FDA Adverse Event Malfunction Summary report: N

ANIMAS VIBE

MDR report key: 7083728 · Received December 5, 2017

Report

Report Number
2531779-2017-27551
Event Type
Malfunction
Date Received
December 5, 2017
Report Date
November 9, 2017
Manufacturer
ANIMAS CORPORATION
Product Code
OYC
PMA / PMN Number
P130007
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER CAREGIVERS

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS NOT BEEN RETURNED TO ANIMAS FOR EVALUATION. IF THE DEVICE IS RETURNED, AN EVALUATION SHALL BE COMPLETED AND A SUPPLEMENTAL REPORT WILL BE FILED. NO CONCLUSIONS CAN BE MADE AT THIS TIME. (B)(6).

Additional Manufacturer Narrative · 1

FOLLOW-UP # 1 DATE OF SUBMISSION 29-JAN-2018. DEVICE EVALUATION: THE DEVICE HAS BEEN RETURNED AND EVALUATED BY PRODUCT ANALYSIS ON 12-JAN-2018 WITH THE FOLLOWING FINDINGS: DURING VISUAL INSPECTION OF THE PUMP, IT WAS OBSERVED THAT THE PUMP WAS RETURNED WITH A DIM AND DISCOLORED DISPLAY. UNRELATED TO THE INITIAL COMPLAINT, IT WAS OBSERVED THAT THE BATTERY COMPARTMENT WAS CRACKED. 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.

Description of Event or Problem · 1

ON (B)(6) 2017, THE REPORTER CONTACTED ANIMAS ALLEGING A DISPLAY (DIM/FADING/COLOR SPECTRUM) ISSUE. IT WAS REPORTED THAT THE DISPLAY SCREEN WAS DIM. THERE WAS NO INDICATION THAT THE DEVICE CAUSED OR CONTRIBUTED TO AN ADVERSE EVENT. THIS COMPLAINT IS BEING REPORTED BECAUSE THE ISSUE MAY IMPACT THE USER'S ABILITY TO READ SOME OR ALL OF THE INFORMATION ON THE SCREEN WHICH MAY RESULT IN OVER OR UNDER DELIVERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
861838 ANIMAS VIBE INSULIN INFUSION PUMP OYC ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1