FDA Adverse Event Malfunction Summary report: N

ANIMAS VIBE

MDR report key: 6357167 · Received February 24, 2017

Report

Report Number
2531779-2017-04338
Event Type
Malfunction
Date Received
February 24, 2017
Report Date
February 2, 2017
Manufacturer
ANIMAS CORPORATION
Product Code
OYC
PMA / PMN Number
P130007
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE EVALUATION: THE PUMP HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 02/02/2017 WITH THE FOLLOWING FINDINGS: THE BATTERY COMPARTMENT WAS CRACKED AND THE DISPLAY WAS DIM AND DISCOLORED. UNRELATED TO THESE ISSUES, THE KEYPAD WAS PEELING. 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. (B)(6).

Description of Event or Problem · 1

THE PUMP WAS RETURNED FOR INVESTIGATION. INVESTIGATION REVEALED THAT THE BATTERY COMPARTMENT WAS CRACKED AND THE DISPLAY WAS DIM AND DISCOLORED. THIS REPORT IS MADE BASED ON RESULTS OF INVESTIGATION COMPLETED ON 02/02/2017.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
141266 ANIMAS VIBE INSULIN INFUSION PUMP OYC ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1