FDA Adverse Event Malfunction Summary report: N

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 3132122 · Received May 29, 2013

Report

Report Number
2531779-2013-07173
Event Type
Malfunction
Date Received
May 29, 2013
Report Date
May 1, 2013
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DATE THE DEVICE HISTORY RECORD REVIEW WAS CONDUCTED ON WAS (B)(6) 2012 AND NOT (B)(6) 2013 AS PREVIOUSLY REPORTED.

Additional Manufacturer Narrative · 1

THE PUMP HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON (B)(4) 2013 WITH THE FOLLOWING FINDINGS: BLACK BOX REVIEW SHOWS MULTIPLE PERSISTENT REPLACE BATTERY ALARMS ON THE REPORTED FAILURE DATE. THE PUMP BOOTED WITH A LOW BATTERY ALARM AND THE DISPLAY WAS DIM. THE PUMP WAS TESTED WITH AN EXTERNAL POWER SUPPLY AND ALL ACTIVE CURRENTS WERE WELL ABOVE SPECIFICATIONS. BATTERY COMPARTMENT AND CAP ARE INTACT WITH NO DAMAGE OR MOISTURE INGRESS OBSERVED. REPLACE BATTERY ALARM WAS DUPLICATED DURING TESTING. THE PUMP COVER WAS REMOVED, THE POWER FLEX AND POWER CIRCUIT WERE TESTED FOR INTERMITTING CONDITIONS, NO DEFECTS WERE FOUND. A TEST DISPLAY WAS USED FOR TESTING PURPOSES, ALL CURRENT READING RETURNED TO NORMAL SPECIFICATIONS. (B)(6). DEVICE HISTORY RECORD REVIEW WAS CONDUCTED ON (B)(4) 2013 WITH THE FOLLOWING FINDINGS. 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.

Description of Event or Problem · 1

THE PUMP WAS RETURNED FOR INVESTIGATION. INVESTIGATION REVEALED THAT THE DISPLAY WAS FOUND TO BE DIM. THIS REPORT IS MADE BASED ON RESULTS OF INVESTIGATION COMPLETED ON (B)(4) 2013.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
235507 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1 47 YR