FDA Adverse Event Malfunction Summary report: N

ANIMAS VIBE

MDR report key: 3936081 · Received July 15, 2014

Report

Report Number
2531779-2014-20161
Event Type
Malfunction
Date Received
July 15, 2014
Report Date
July 7, 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

THE DEVICE HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 08/06/2014 WITH THE FOLLOWING FINDINGS: VISUAL INSPECTION REVEALED THAT THE DISPLAY SCREEN TEXT WAS DIM, FADED, AND DISCOLORED. THE PUMP WAS RETURNED WITH THE CONTRAST SETTING AT 5; THE CONTRAST SETTING WAS INCREASED TO THE MAXIMUM OF 10 DURING TESTING, WITH LITTLE IMPROVEMENT OBSERVED.

Description of Event or Problem · 1

ON (B)(6) 2014, THE REPORTER CONTACTED ANIMAS, ALLEGING A DISPLAY (DIM/FADING/COLOR SPECTRUM) 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
414016 ANIMAS VIBE INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1