FDA Adverse Event Malfunction Summary report: N

ANIMAS VIBE

MDR report key: 3790108 · Received May 5, 2014

Report

Report Number
2531779-2014-12458
Event Type
Malfunction
Date Received
May 5, 2014
Report Date
April 24, 2014
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS NOT BEEN RETURNED TO ANIMAS FOR EVALUATION. 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. (B)(6).

Additional Manufacturer Narrative · 1

FOLLOW-UP # 1 DATE OF SUBMISSION 06/27/2014-DEVICE EVALUATION: THE PUMP HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 06/17/2014 WITH THE FOLLOWING RESULTS:A REVIEW OF THE PUMP¿S HISTORY SHOWED NO EVIDENCE OF SHORT BATTERY LIFE; A LOW BATTERY WARNING WAS OBSERVED DUE TO A DISCHARGED BATTERY BEING USED. NO SHORT BATTERY LIFE WAS DUPLICATED DURING INVESTIGATION AND THE PUMP¿S CURRENT DRAWS WERE FOUND TO BE IN SPECIFICATIONS. THE PUMP COVER WAS OPENED AND NO INTERMITTENT CONNECTION WAS FOUND TO THE POWER CIRCUIT. 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

ON (B)(6) 2014, THE REPORTER CONTACTED ANIMAS, ALLEGING A POWER (BATTERY LIFE) ISSUE. 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
266558 ANIMAS VIBE INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1