BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CONTACT DETACH

    MDR report key: 23462184 · Received November 4, 2025

    Report

    Report Number
    3003442380-2025-15753
    Event Type
    Malfunction
    Date Received
    November 4, 2025
    Date of Event
    October 9, 2025
    Report Date
    December 1, 2025
    Manufacturer
    UNOMEDICAL DEVICES S.A. DE C.V.
    Product Code
    FPA
    UDI-DI
    05705244018488
    PMA / PMN Number
    K041545
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 0

    ADDITIONAL INFORMATION - THIS MDR IS BEING SUBMITTED TO INCLUDE THE BELOW: H6: INVESTIGATION RESULTS UNDER TYPE OF INVESTIGATION, INVESTIGATION FINDINGS, INVESTIGATION CONCLUSIONS. H11: INVESTIGATION SUMMARY. COMPLAINT INVESTIGATION RESULTS: A COMPLAINT INVESTIGATION HAS BEEN INITIATED TO REVIEW THE DEVICE HISTORY RECORD (DHR) ASSOCIATED WITH THE REPORTED ISSUE. THE BATCH 6010327, IN QUESTION WAS MANUFACTURED AT THE REYNOSA SITE. DEVICE HISTORY RECORD (DHR) REVIEW: THE LOT 6010327 WAS MANUFACTURED ACCORDING TO THE FORM-4902137 VERSION 98.0, IN THE MULTIVAC M14, ON 26/NOV/2024, WITH A TOTAL OF (B)(4) UNITS. THE SUB-ASSEMBLY: GLUING OF TUBING THE LOT 4K05854 WAS MANUFACTURED ACCORDING TO THE FORM VERSION 65.0 AND MANUFACTURED IN THE LINE SC05-SC06, ON 26/NOV/2024, WITH A TOTAL OF (B)(4) UNITS. THE LOT 4K05853 WAS MANUFACTURED ACCORDING TO THE FORM VERSION 65.0 AND MANUFACTURED IN THE LINE SC05-SC06, ON 23/NOV/2024, WITH A TOTAL OF (B)(4) UNITS. THE SUB-ASSEMBLY: GLUING OF CONNECTOR THE LOT 4K05776 WAS MANUFACTURED ACCORDING TO THE FORM VERSION 37.0 IN THE GLUING OF CONNECTOR IN THE LINE 03, ON 14/NOV/2024, WITH A TOTAL OF (B)(4) UNITS. THE LOT 4L03430 WAS MANUFACTURED ACCORDING TO THE FORM VERSION 37.0 IN THE GLUING OF CONNECTOR IN THE LINE 03, ON 25/NOV/2024, WITH A TOTAL OF (B)(4) UNITS. THE LOT 4L03431 WAS MANUFACTURED ACCORDING TO THE FORM VERSION 37.0 IN THE GLUING OF CONNECTOR IN THE LINE 03, ON 26/NOV/2024, WITH A TOTAL OF (B)(4) UNITS. THE LOT 4L03432 WAS MANUFACTURED ACCORDING TO THE FORM VERSION 37.0 IN THE GLUING OF CONNECTOR IN THE LINE 03, ON 26/NOV/2024, WITH A TOTAL OF (B)(4) UNITS. REVIEW OF THE DEVICE HISTORY RECORD (DHR) SHOWED THAT ALL RELEVANT TESTS REQUIRED DURING THE RELATED PROCESSES HAD BEEN FULFILLED AND MET THE REQUIREMENTS. NO DEVIATION WAS IDENTIFIED, NOR MAINTENANCE EVENTS WERE RECORDED RELATED TO COMPLAINT CODE. NOTE: EXTENDED BY CONTAMINATION. CONCLUSION SUMMARY OF COMPLAINT INVESTIGATION: AS A RESULT OF THE FOLLOWING: NO NON-CONFORMANCE (NC) RAISED DURING PRODUCTION RELATED TO COMPLAINT CODE, NO TREND IDENTIFIED FOR THE LOT IN QUESTION AND MALFUNCTION CODE, NO FURTHER ACTIONS ARE REQUIRED. THIS COMPLAINT WILL NOT REQUIRE FURTHER ROOT CAUSE INVESTIGATION NOR CORRECTIVE AND PREVENTIVE ACTION (CAPA) PLAN. THEREFORE, THIS ISSUE WILL BE MONITORED THROUGH THE POST MARKET SURVEILLANCE ACTIVITIES.

    Description of Event or Problem · 0

    TO DATE NO ADDITIONAL PATIENT OR EVENT DETAILS HAVE BEEN RECEIVED.

    Description of Event or Problem · 0

    REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT THE PATIENT FACED INSULIN FLOW BLOCKED ALARM EVENT ON (B)(6) 2025. THE BLOCKAGE WAS IN THE TUBING. THE PATIENT CHANGED SUPPLIES AS NECESSARY AND RESUMED INSULIN THERAPY. NO FURTHER INFORMATION AVAILABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    211950 CONTACT DETACH UNO CONTACT DETACH G29 60/8TCAP 10PK INT FPA UNOMEDICAL DEVICES S.A. DE C.V. 1002835 6010327 05705244018488

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Male