BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ONETOUCHPING GLUCOSEMGMTSYSTEM

    MDR report key: 4092855 · Received September 16, 2014

    Report

    Report Number
    2531779-2014-26363
    Event Type
    Malfunction
    Date Received
    September 16, 2014
    Report Date
    September 2, 2014
    Manufacturer
    ANIMAS CORPORATION
    Product Code
    LZG
    PMA / PMN Number
    K080639
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KY, US
    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.

    Additional Manufacturer Narrative · 1

    DEVICE EVALUATION: THE DEVICE HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 10/28/2014 WITH THE FOLLOWING FINDINGS: PUMP POWERS WITH RETURNED BATTERY CAP TO A DIM DISCOLORED DISPLAY. BATTERY CAP IS ABLE TO FULLY TIGHTEN. BATTERY COMPARTMENT CRACK OBSERVED BELOW GRIP PAD.. BLACK BOX DATES FROM (B)(6) 2014 - (B)(6) 2014. NO EVIDENCE OF SHORT BATTERY LIFE OBSERVED IN BLACK BOX HOWEVER MULTIPLE EAW 128 REPLACE BATTERY ALARMS OBSERVED IN ALARM HISTORY. UNABLE TO DUPLICATE FREQUENCY OF REPLACE BATTERY ALARMS. CURRENT DRAWS WITHIN SPECIFICATIONS. REMOVED PUMP CASE, NO EVIDENCE OF MOISTURE OR LOOSE COMPONENTS INSIDE PUMP.

    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
    571353 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

    Patients

    Seq Age Sex Outcome Treatment
    1 14 YR