FDA Adverse Event Malfunction Summary report: N

ILET BIONIC PANCREAS

MDR report key: 23903233 · Received December 27, 2025

Report

Report Number
3019004087-2025-17488
Event Type
Malfunction
Date Received
December 27, 2025
Date of Event
December 16, 2025
Report Date
December 27, 2025
Manufacturer
BETA BIONICS INC.
Product Code
QFG
UDI-DI
00850050080190
PMA / PMN Number
K231485
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 0

IT WAS REPORTED THAT A USER EXPERIENCED HYPERGLYCEMIA WHILE USING AN ILET SYSTEM AFTER A SUPPLY CHANGE, WITH A REPORTED BLOOD GLUCOSE OF 338 MG/DL; THE AGENT INSTRUCTED ANOTHER SUPPLY CHANGE, RESUMED INSULIN DELIVERY, AND ARRANGED REPLACEMENT SUPPLIES, NOTING PRIOR PREMATURE CHANGES OF INFUSION COMPONENTS (CARTRIDGE LOT 34974, CONNECTOR LOT 35096, TEFLON INSET LOT 6010685). SYMPTOMS INCLUDED ELEVATED BLOOD GLUCOSE TO A PEAK OF 400 MG/DL. OUTCOMES INCLUDED USER TROUBLESHOOTING AND REPLACEMENT SUPPLIES. INVESTIGATION INCLUDED CUSTOMER INTERVIEW AND GUIDED TROUBLESHOOTING. INVESTIGATION OF THIS CASE REVEALED THAT THE CAUSE OF THE HYPERGLYCEMIA WAS UNCLEAR, WITH NO ALERTS OR ALARMS REPORTED AND NO DEVICE MALFUNCTION CONFIRMED. IT WAS CONCLUDED, BASED ON PREVIOUSLY ESTABLISHED FINDINGS FOR SIMILAR REPORTS, THAT THE CAUSE WAS UNDETERMINED. IF THE DEVICE IS RETURNED, A PHYSICAL EVALUATION WILL BE PERFORMED, AND A SUPPLEMENTAL WILL BE SUBMITTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2311924 ILET BIONIC PANCREAS ALTERNATE CONTROLLER ENABLED INSULIN INFUSION PUMP QFG BETA BIONICS INC. 00850050080190

Patients

Seq Age Sex Outcome Treatment
1 82 YR Unknown