FDA Adverse Event Malfunction Summary report: N

ANIMAS VIBE

MDR report key: 3941816 · Received July 17, 2014

Report

Report Number
2531779-2014-20460
Event Type
Malfunction
Date Received
July 17, 2014
Report Date
June 30, 2014
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
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. 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

DEVICE EVALUATION: THE DEVICE HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 08/19/2014 WITH THE FOLLOWING FINDINGS:VISUAL INSPECTION REVEALED CORROSION IN THE BATTERY COMPARTMENT. THERE WAS A SMALL CRACK OBSERVED AT THE OPENING OF THE BATTERY COMPARTMENT. THE PUMP WOULD NOT POWER ON AT THE TIME OF INVESTIGATION DUE TO THE CORROSION. THERE WAS NO OTHER EVIDENCE OF MOISTURE INGRESS OBSERVED INSIDE THE PUMP.

Description of Event or Problem · 1

ON (B)(6) 2014, THE REPORTER CONTACTED ANIMAS, ALLEGING THAT THERE WAS MOISTURE IN THE BATTERY COMPARTMENT. 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
419042 ANIMAS VIBE INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1 31 YR