FDA Adverse Event Malfunction Summary report: N

ILET BIONIC PANCREAS

MDR report key: 25284156 · Received May 26, 2026

Report

Report Number
3019004087-2026-48462
Event Type
Malfunction
Date Received
May 26, 2026
Date of Event
May 20, 2026
Report Date
May 26, 2026
Manufacturer
BETA BIONICS, INC.
Product Code
QFG
UDI-DI
00850050080206
PMA / PMN Number
K231485
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

INITIAL.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE USER EXPERIENCED AN ¿UNABLE TO PROCEED¿ ALERT IDENTIFIED AS A MOTOR STALL DURING A SUPPLY CHANGE, AFTER WHICH A DRY RUN WITHOUT SUPPLIES WAS SUCCESSFUL AND A SUBSEQUENT SUPPLY CHANGE WITH NEW COMPONENTS ALLOWED DELIVERY TO RESUME; THE USER REPORTED LOT NUMBERS FOR CONNECTOR 862177262, CARTRIDGES 32492, AND INSET 6011055. SYMPTOMS INCLUDED NO REPORTED ADVERSE CLINICAL EFFECTS. OUTCOMES INCLUDED NO INTERRUPTION IN THERAPY BEYOND THE TRANSIENT EVENT AND NO MEDICAL INTERVENTION. INVESTIGATION INCLUDED GUIDED TROUBLESHOOTING, REMOVAL OF ALL SUPPLIES, A SUCCESSFUL DRY RUN, AND REINSTALLATION OF NEW SUPPLIES WITH SUCCESSFUL RESUMPTION OF INSULIN DELIVERY. INVESTIGATION OF THIS CASE REVEALED THAT THE CONSECUTIVE STALLED MOTOR CONDITION WAS NOT REPRODUCED AFTER RESEATING AND REPLACING DISPOSABLE COMPONENTS, CONSISTENT WITH A TRANSIENT SUPPLY OR INSTALLATION ISSUE AFFECTING THE DELIVERY MECHANISM. IT WAS CONCLUDED, BASED ON PREVIOUSLY ESTABLISHED FINDINGS FOR SIMILAR REPORTS, THAT THE CAUSE WAS INCONCLUSIVE BUT CONSISTENT WITH INCORRECT OR INCOMPLETE SETUP THAT RESOLVED WITH PROPER REINSTALLATION. 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
185364 ILET BIONIC PANCREAS ALTERNATE CONTROLLER ENABLED INSULIN INFUSION PUMP QFG BETA BIONICS, INC. 00850050080206

Patients

Seq Age Sex Outcome Treatment
1