FDA Adverse Event Malfunction Summary report: N

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 2233142 · Received September 2, 2011

Report

Report Number
2531779-2011-06445
Event Type
Malfunction
Date Received
September 2, 2011
Report Date
August 5, 2011
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

THE PUMP WAS RETURNED TO ANIMAS. ADHESIVE WAS FOUND UNDER THE KEYPAD BUTTON CONTACTS. ALL BUTTONS WERE INTERMITTENTLY ACTIVATING PUMP FUNCTIONS WHEN PRESSED. THERE WAS NO MOISTURE FOUND IN THE PUMP. ANIMAS HAS CONDUCTED A REVIEW OF THE DEVICE HISTORY RECORD FOR THIS PUMP AND CONFIRMED THAT IT WAS OPERATING WITHIN REQUIRED SPECIFICATIONS AT THE TIME OF RELEASE.

Description of Event or Problem · 1

THE PATIENT STATED THE BACKLIGHT BUTTONS WORKS BUT THE OTHER BUTTONS DO NOT RESPOND TO BUTTON PRESSES. THE PATIENT NOTICED THE ISSUE AFTER HE WENT SWIMMING WITH THE PUMP. THE PATIENT FOUND NO VISIBLE MOISTURE IN THE BATTERY COMPARTMENT AND NO CRACKS IN THE PUMP. THERE WAS NO REPORTED PATIENT IMPACT ASSOCIATED WITH THIS COMPLAINT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION ONETOUCH PING INSULIN PUMP

Patients

Seq Age Sex Outcome Treatment
1 29 YR