FDA Adverse Event Malfunction Summary report: N

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 2961894 · Received February 14, 2013

Report

Report Number
2531779-2013-01779
Event Type
Malfunction
Date Received
February 14, 2013
Report Date
February 2, 2013
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

FOLLOW-UP # 1 DATE OF SUBMISSION (B)(4) 2013 - DEVICE EVALUATION: THE PUMP HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON (B)(4) 2013 WITH THE FOLLOWING FINDINGS: DURING EVALUATION, MOISTURE DAMAGE WAS OBSERVED IN THE DISPLAY AND BATTERY COMPARTMENT. DURING INVESTIGATION, THE PUMP DID NOT POWER ON AND ADDITIONAL TESTING COULD NOT BE PERFORMED. EVALUATION ALSO REVEALED A DISPLAY LENS LEAK. THE PUMP WAS OPENED AND MOISTURE DAMAGE WAS FOUND ON THE CIRCUIT BOARD. UNRELATED TO THE COMPLAINT, THE DISPLAY SCREEN WAS FOUND TO BE SCRATCHED.

Additional Manufacturer Narrative · 1

THE PUMP HAS NOT BEEN RETURNED TO ANIMAS FOR EVALUATION. 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. IF THE DEVICE IS RETURNED, AN EVALUATION SHALL BE COMPLETED AND A SUPPLEMENTAL REPORT WILL BE FILED. NO CONCLUSIONS CAN BE MADE AT THIS TIME.

Description of Event or Problem · 1

THE PATIENT CONTACTED ANIMAS ON (B)(6) 2013 REPORTING THAT THE PUMP WAS HOT TO TOUCH. THE PATIENT REPORTED WATER INTRUSION BEHIND THE DISPLAY SCREEN. THERE IS NO REPORTED ADVERSE EVENT WITH THIS COMPLAINT. THIS REPORT IS MADE BASED ON THE ALLEGATION OF THE HOT PUMP ISSUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
66022 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION ONETOUCH PING INSULIN PUMP

Patients

Seq Age Sex Outcome Treatment
1 46 YR