FDA Adverse Event Malfunction Summary report: N

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 3811658 · Received May 15, 2014

Report

Report Number
2531779-2014-13693
Event Type
Malfunction
Date Received
May 15, 2014
Report Date
May 8, 2014
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

FOLLOW-UP #1: DATE OF SUBMISSION 06/23/2016. DEVICE EVALUATION: THE DEVICE HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 06/06/2016 WITH THE FOLLOWING FINDINGS: BLACK BOX SHOWS DATES FROM (B)(4) 2016, (B)(4) 2007. BLACK BOX DATA FROM DATE OF COMPLAINT HAS BEEN OVERWRITTEN. UNABLE TO CONFIRM OR DUPLICATE COMPLAINT DURING INVESTIGATION. NO BATTERY CAP OR CARTRIDGE CAP WAS RETURNED. ALL TESTING PERFORMED WITH TEST CAPS. THE BATTERY CAP IS ABLE TO FULLY TIGHTEN. CURRENT DRAWS ARE WITHIN SPECIFICATIONS A "BATTERY LIFE" ISSUE WAS NOT DUPLICATED DURING THE INVESTIGATION. REMOVED PUMP CASE AND DISASSEMBLED PUMP. NO EVIDENCE OF MOISTURE OR LOOSE COMPONENTS OBSERVED INSIDE PUMP. 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.

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.

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
291965 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1 13 YR