FDA Adverse Event Malfunction Summary report: Y

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 5830427 · Received July 28, 2016

Report

Report Number
2531779-2016-17859
Event Type
Malfunction
Date Received
July 28, 2016
Report Date
June 30, 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

OF THE 1583 ALLEGATIONS OF A MALFUNCTION, 966 PUMPS WERE RETURNED TO ANIMAS AND INVESTIGATED. OF THE INVESTIGATED PUMPS, 909 WERE FOUND TO BE MALFUNCTIONING DUE TO A DIM AND DISCOLORED DISPLAY. DURING INVESTIGATION FOR UNRELATED ALLEGATIONS, THERE WERE 902 ADDITIONAL INSTANCES OF A DIM AND DISCOLORED DISPLAY SCREEN. THIS REPORT IS PROCESSED UNDER EXEMPTION NUMBER E2015053. THIS MDR REPORT IS PART OF THE 227 PILOT PROGRAM.

Additional Manufacturer Narrative · 0

FOLLOW UP #3 04/21/2017 DEVICE EVALUATION: IN Q1 2017 THERE WERE 21 ADDITIONAL INSTANCES OF DIM/FADING/COLOR SPECTRUM 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.

Additional Manufacturer Narrative · 0

FOLLOW-UP #1 DATE OF SUBMISSION 10/25/2016 - DEVICE EVALUATION: IN Q3 2016 72 PUMPS WERE RETURNED AND INVESTIGATED. THERE WERE 67 INSTANCES OF DIM/FADING/COLOR SPECTRUM ISSUES 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

IN Q4 2016 THERE WERE 40 ADDITIONAL INSTANCES OF DIM/FADING COLOR SPECTRUM 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 #4 07/28/2017 DEVICE EVALUATION: IN Q2 2017, THERE WERE 10 INSTANCES OF DIM AND DISCOLORED DISPLAY FAILURE 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

FOLLOW-UP #5: DATE OF SUBMISSION 10/30/2017 - DEVICE EVALUATION: IN Q3 2017, THERE WERE 5 INSTANCES OF DIM/FADING/COLOR SPECTRUM FAILURE 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

FOLLOW UP #7 26-APR-2018 DEVICE EVALUATION: IN Q1 2018, THERE WERE 7 INSTANCES OF DIM/FADING/COLOR SPECTRUM FAILURE 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

FOLLOW UP #6 30-JAN-2018 DEVICE EVALUATION: IN Q4 2017, THERE WERE 3 INSTANCES OF DIM/FADING/COLOR SPECTRUM 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 MALFUNCTION EVENTS. A REVIEW OF THE EVENTS INDICATED THAT THE ONE TOUCH PING MODEL PUMP EXPERIENCED A DIM AND FADING DISPLAY SCREEN ISSUE. THESE REPORTS WERE RECEIVED FROM VARIOUS SOURCES. THE PATIENTS ASSOCIATED WITH THIS ALLEGATION RANGED FROM 4-92 YEARS OF AGE AND BETWEEN 0 AND 370 POUNDS. OF THE REPORTED PATIENTS, 639 WERE MALE, 802 WERE FEMALE, AND 142 WERE UNKNOWN.

Additional Manufacturer Narrative · 1

FOLLOW-UP #1: DATE OF SUBMISSION 19-JUL-2018 - DEVICE EVALUATION: IN QUARTER 2 OF 2018, THERE WERE 2 INSTANCES OF DIM/FADING/COLOR SPECTRUM FAILURE FOUND DURING INVESTIGATION. THIS REPORT IS PROCESSED UNDER EXEMPTION NUMBER (B)(4). THIS MDR REPORT IS PART OF THE 227 PILOT PROGRAM.

Additional Manufacturer Narrative · 1

DEVICE EVALUATION: IN QUARTER 3 OF 2018, THERE WERE 3 INSTANCES OF DIM/FADING/COLOR SPECTRUM FAILURE FOUND DURING INVESTIGATION. THIS REPORT IS PROCESSED UNDER THE VOLUNTARY MALFUNCTION SUMMARY REPORTING PROGRAM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
484535 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1