FDA Adverse Event Malfunction Summary report: N

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 3111986 · Received May 14, 2013

Report

Report Number
2531779-2013-06370
Event Type
Malfunction
Date Received
May 14, 2013
Report Date
April 19, 2013
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS NOT BEEN RETURNED TO ANIMAS. 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

ON (B)(6) 2013, THE REPORTER CONTACTED ANIMAS, ALLEGING A DISPLAY (DIM/FADING) ISSUE. THE REPORTER STATED THAT THE DISPLAY SCREEN IS DIFFICULT TO READ. THIS COMPLAINT IS BEING REPORTED BECAUSE THE REPORTED ISSUE WAS NOT RESOLVED WITH TROUBLESHOOTING. THERE WAS NO INDICATION THAT THE PRODUCT CAUSED OR CONTRIBUTED TO AN ADVERSE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
212571 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1 44 YR