BEUDAMED
    FDA Adverse Event Death Summary report: N

    ANIMAS INSULIN INFUSION PUMP

    MDR report key: 645225 · Received November 7, 2005

    Report

    Report Number
    2531779-2005-00189
    Event Type
    Death
    Date Received
    November 7, 2005
    Date of Event
    October 7, 2005
    Report Date
    October 7, 2005
    Manufacturer
    ANIMAS CORP.
    Product Code
    LZG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MT, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT'S CERTIFIED DIABETES EDUCATOR REPORTED THEY HAD PASSED AWAY FROM DKA.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ANIMAS INSULIN INFUSION PUMP INSULIN INFUSION PUMP LZG ANIMAS CORP. IR 1250 *

    Patients

    Seq Age Sex Outcome Treatment
    1 25 YR Death