FDA Adverse Event Malfunction Summary report: N

ANIMAS VIBE

MDR report key: 5243339 · Received November 23, 2015

Report

Report Number
2531779-2015-42568
Event Type
Malfunction
Date Received
November 23, 2015
Report Date
November 6, 2015
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
P130007
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE EVALUATION: THE PUMP HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 11/06/2015 WITH THE FOLLOWING FINDINGS: INVESTIGATION REVEALED THAT THE BATTERY CAP¿S COIN SLOT WAS DAMAGED, MAKING THE CAP DIFFICULT TO REMOVE. UNRELATED TO THE BATTERY CAP ISSUE, INVESTIGATION REVEALED THAT THE AUDIO BOLUS BUTTON COVER WAS MISSING. (B)(6).

Description of Event or Problem · 1

THE PUMP WAS RETURNED FOR INVESTIGATION. INVESTIGATION REVEALED THAT THE BATTERY CAP WAS DAMAGED. THIS REPORT IS MADE BASED ON RESULTS OF INVESTIGATION COMPLETED ON 11/06/2015.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
772514 ANIMAS VIBE INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1