FDA Adverse Event Malfunction Summary report: Y

ONETOUCHPING GLUCOSEMGMTSYSTEM

MDR report key: 7224579 · Received January 29, 2018

Report

Report Number
2531779-2018-02183
Event Type
Malfunction
Date Received
January 29, 2018
Report Date
January 1, 2018
Manufacturer
ANIMAS CORPORATION
Product Code
LZG
PMA / PMN Number
K080639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER CAREGIVERS

Narratives

Additional Manufacturer Narrative · 0

OF THE 44 ALLEGATIONS OF A MALFUNCTION, 31 PUMPS WERE RETURNED TO ANIMAS AND INVESTIGATED. OF THE INVESTIGATED PUMPS, 5 WERE FOUND TO BE MALFUNCTIONING DUE TO CRACKED TRANSCEIVER FLEXES. 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 26-APR-2018 DEVICE EVALUATION:IN Q1 2018, THERE WERE 7 INSTANCES OF CS 052/053/054/055 SLEEP 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 SUMMARIZE 44 MALFUNCTION EVENTS. A REVIEW OF THE EVENTS INDICATED THAT THE ONE TOUCH PING MODEL PUMP EXPERIENCED A CS 052/053/054/055 SLEEP ISSUE. THESE REPORTS WERE RECEIVED FROM VARIOUS SOURCES. THE PATIENTS ASSOCIATED WITH THIS ALLEGATION RANGED FROM 7-73 YEARS OF AGE AND BETWEEN 27 AND 320 POUNDS. OF THE REPORTED PATIENTS, 30 WERE MALE, 14 WERE FEMALE, AND WERE UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
69451 ONETOUCHPING GLUCOSEMGMTSYSTEM INSULIN INFUSION PUMP LZG ANIMAS CORPORATION

Patients

Seq Age Sex Outcome Treatment
1