FDA Adverse Event Malfunction Summary report: Y

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 5614380 · Received April 28, 2016

Report

Report Number
2531779-2016-08720
Event Type
Malfunction
Date Received
April 28, 2016
Report Date
March 31, 2016
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

FOLLOW-UP #2 DATE OF SUBMISSION 07/27/2016 - DEVICE EVALUATION: IN Q2 2016 18 PUMPS WERE RETURNED AND INVESTIGATED. THERE WERE 12 INSTANCES OF BATTERY COMPARTMENT DAMAGE FOUND DURING INVESTIGATION. THIS REPORT IS PROCESSED UNDER EXEMPTION NUMBER E2015053. THIS MDR REPORT IS PART OF THE 227 PILOT PROGRAM. THIS REPORT IS MADE UNDER THE REQUIREMENTS OF THE MEDICAL DEVICE REPORTING REGULATIONS AND DOES NOT CONSTITUTE AN ADMISSION ON THE PART OF ANIMAS OF ANY DEFICIENCY IN THE PERFORMANCE OF THE DEVICE.

Additional Manufacturer Narrative · 0

FOLLOW-UP #4 DATE OF SUBMISSION 10/25/2016 - DEVICE EVALUATION: IN Q3 2016 1 PUMP WAS RETURNED AND INVESTIGATED. THERE WAS 1 INSTANCE OF BATTERY COMPARTMENT DAMAGE FOUND DURING INVESTIGATION. THIS REPORT IS PROCESSED UNDER EXEMPTION NUMBER E2015053. THIS MDR REPORT IS PART OF THE 227 PILOT PROGRAM.

Additional Manufacturer Narrative · 0

OF THE (B)(4) ALLEGATIONS OF A MALFUNCTION, (B)(4) PUMPS WERE RETURNED TO ANIMAS AND INVESTIGATED. OF THE INVESTIGATED PUMPS, (B)(4) WERE FOUND TO BE MALFUNCTIONING DUE TO DAMAGE TO THE BATTERY COMPARTMENT. DURING INVESTIGATION FOR UNRELATED ALLEGATIONS, THERE WERE (B)(4) ADDITIONAL BATTERY COMPARTMENT FAILURES REVEALED DURING PRODUCT INVESTIGATION ALSO DUE TO DAMAGE TO THE BATTERY COMPARTMENT. THIS REPORT IS PROCESSED UNDER EXEMPTION NUMBER E2015053. THIS MDR REPORT IS PART OF THE 227 PILOT PROGRAM.

Additional Manufacturer Narrative · 0

FOLLOW UP #1 06/15/2015 OF THE 403 ALLEGATIONS OF A MALFUNCTION, 320 PUMPS WERE RETURNED TO ANIMAS AND INVESTIGATED. OF THE INVESTIGATED PUMPS, 317 WERE FOUND TO BE MALFUNCTIONING DUE TO DAMAGE TO THE BATTERY COMPARTMENT. DURING INVESTIGATION FOR UNRELATED ALLEGATIONS, THERE WERE 320 ADDITIONAL BATTERY COMPARTMENT FAILURES REVEALED DURING PRODUCT INVESTIGATION ALSO DUE TO DAMAGE TO THE BATTERY COMPARTMENT. THIS REPORT IS PROCESSED UNDER EXEMPTION NUMBER E2015053. THIS MDR REPORT IS PART OF THE 227 PILOT PROGRAM.

Additional Manufacturer Narrative · 0

FOLLOW-UP #5 DATE OF SUBMISSION 01/26/2017 - DEVICE EVALUATION: IN Q4 2016 THERE WERE 3 ADDITIONAL INSTANCES OF BATTERY COMPARTMENT FAILURES FOUND DURING INVESTIGATION OF PUMPS RETURNED UNDER THIS REPORT. THIS REPORT IS PROCESSED UNDER EXEMPTION NUMBER E2015053. THIS MDR REPORT IS PART OF THE 227 PILOT PROGRAM. THIS REPORT IS MADE UNDER THE REQUIREMENTS OF THE MEDICAL DEVICE REPORTING REGULATIONS AND DOES NOT CONSTITUTE AN ADMISSION ON THE PART OF ANIMAS OF ANY DEFICIENCY IN THE PERFORMANCE OF THE DEVICE.

Additional Manufacturer Narrative · 0

FOLLOW-UP #6: DATE OF SUBMISSION 10/30/2017 - DEVICE EVALUATION: IN Q3 2017, THERE WERE 2 INSTANCES OF BATTERY COMPARTMENT FAILURE FOUND DURING INVESTIGATION. THIS REPORT IS PROCESSED UNDER EXEMPTION NUMBER E2015053. THIS MDR REPORT IS PART OF THE 227 PILOT PROGRAM.

Description of Event or Problem · 0

THIS REPORT SUMMARIZES <NOE> 403</NOE> MALFUNCTION EVENTS. A REVIEW OF THE EVENTS INDICATED THAT THE ONE TOUCH PING MODEL PUMP EXPERIENCED A DAMAGED BATTERY COMPARTMENT. THESE REPORTS WERE RECEIVED FROM VARIOUS SOURCES. THE PATIENTS ASSOCIATED WITH THIS ALLEGATION RANGED FROM 0-79 YEARS OF AGE AND BETWEEN 24 AND 426 POUNDS. OF THE REPORTED PATIENTS, 185 WERE MALE, 218 WERE FEMALE, AND 0 WERE UNKNOWN.

Additional Manufacturer Narrative · 1

OF THE 403 ALLEGATIONS OF A MALFUNCTION, 320 PUMPS WERE RETURNED TO ANIMAS AND INVESTIGATED. OF THE INVESTIGATED PUMPS, 317 WERE FOUND TO BE MALFUNCTIONING DUE TO DAMAGE TO THE BATTERY COMPARTMENT. DURING INVESTIGATION FOR UNRELATED ALLEGATIONS, THERE WERE 320 ADDITIONAL BATTERY COMPARTMENT FAILURES REVEALED DURING PRODUCT INVESTIGATION ALSO DUE TO DAMAGE TO THE BATTERY COMPARTMENT.

Additional Manufacturer Narrative · 1

FOLLOW-UP #9: DATE OF SUBMISSION 10-JUL-2019. DEVICE EVALUATION: IN QUARTER 2 OF 2019, THERE WERE 1 INSTANCES OF BATTERY COMPARTMENT FAILURE FOUND DURING INVESTIGATION. THIS REPORT IS PROCESSED UNDER THE VOLUNTARY MALFUNCTION SUMMARY REPORTING PROGRAM.

Additional Manufacturer Narrative · 1

DEVICE EVALUATION: IN QUARTER 4 OF 2018, THERE WERE 1 INSTANCES OF BATTERY COMPARTMENT FAILURE FOUND DURING INVESTIGATION. THIS REPORT IS PROCESSED UNDER THE VOLUNTARY MALFUNCTION SUMMARY REPORTING PROGRAM

Additional Manufacturer Narrative · 1

DEVICE EVALUATION: IN QUARTER 1 OF 2019, THERE WAS 1 INSTANCE OF BATTERY COMPARTMENT FAILURE FOUND DURING INVESTIGATION. THIS REPORT IS PROCESSED UNDER THE VOLUNTARY MALFUNCTION SUMMARY REPORTING PROGRAM.

Description of Event or Problem · 1

THIS REPORT SUMMARIZES <NOE> 403</NOE> MALFUNCTION EVENTS. A REVIEW OF THE EVENTS INDICATED THAT THE ONE TOUCH PING MODEL PUMP EXPERIENCED A DAMAGED BATTERY COMPARTMENT. THESE REPORTS WERE RECEIVED FROM VARIOUS SOURCES. THE PATIENTS ASSOCIATED WITH THIS ALLEGATION RANGED FROM (B)(6) YEARS OF AGE AND BETWEEN (B)(6) POUNDS. OF THE REPORTED PATIENTS, 185 WERE MALE, 218 WERE FEMALE, AND 0 WERE UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
272151 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1