MAUDE Adverse Event Report: AUTOSOFT XC; UNO INSET I 60/6 BLUE TCAP 10PK INT

Lot Number UNKNOWN

Device Problem Material Twisted/Bent (2981)

Patient Problem Diabetic Ketoacidosis (2364)

Event Type  Injury  

Event Description

Unomedical reference number (b)(4).Event occurred in the united states.It was reported that the 16-years-old male child patient faced a bent cannula which led to high blood glucose level.They tried to treat it with bolus via pump, multiple daily injection and changed infusion set but on (b)(6) 2022, he first went to the emergency room and was subsequently hospitalized due to high blood glucose level.Further, the patient was transferred to the intensive care unit.The patient's highest blood glucose level was over 1000 mg/dl and high ketone level which the healthcare professional did not assess as dangerous or life-threatening.Moreover, the issue occurred with two similar types of infusion set and the site location was patient's abdomen.During hospitalization, the patient received fluids of saline (unknown), insulin, and unspecified medication (drug name unknown) intravenously as corrective treatment which resolved the issue.On (b)(6) 2022, the patient was released from the hospital with no permanent damage.Unomedical do not see bent/kinking as being related to human factors, but rather as a training issue including correct choices of insertion sites and infusion sets and cannula length.Furthermore, the soft cannula is a flexible material that during use and upon removal can bend slightly.No further information was available.

• Brand Name: AUTOSOFT XC
• Type of Device: UNO INSET I 60/6 BLUE TCAP 10PK INT
• Manufacturer Contact: aaholmvej 1-3; osted; lejre, 4320
• MDR Report Key: 18872960
• MDR Text Key: 337291770
• Report Number: 3003442380-2024-00174
• Device Sequence Number: 1
• Product Code: FPA
• UDI-Device Identifier: 05705244016712
• UDI-Public: 05705244016712
• Combination Product (y/n): N
• PMA/PMN Number: K032854
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Distributor
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 03/11/2024

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 03/11/2024
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Lot Number: UNKNOWN
• Date Manufacturer Received: 03/01/2024
• Patient Sequence Number: 1