FDA Adverse Event Malfunction Summary report: N

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 6487384 · Received April 12, 2017

Report

Report Number
2531779-2017-07569
Event Type
Malfunction
Date Received
April 12, 2017
Report Date
March 22, 2017
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 03/22/2017 WITH THE FOLLOWING FINDINGS: THE PUMP WAS POWERED ON TO A DIM AND PINK DISPLAY. EVIDENCE OF MOISTURE CORROSION WAS FOUND IN THE BATTERY COMPARTMENT. (B)(6).

Description of Event or Problem · 1

THE PUMP WAS RETURNED FOR INVESTIGATION. INVESTIGATION REVEALED THE DISPLAY WAS DIM AND THERE WAS MOISTURE IN THE BATTERY COMPARTMENT. THIS REPORT IS MADE BASED ON RESULTS OF INVESTIGATION COMPLETED ON 03/22/2017.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
269340 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1 49 YR