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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: UNOMEDICAL A/S INSET GUARD; SET, ADMINISTRATION, INTRAVASCULAR

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UNOMEDICAL A/S INSET GUARD; SET, ADMINISTRATION, INTRAVASCULAR Back to Search Results
Model Number MMT-443AJ
Medical Device Problem Codes Loss of or Failure to Bond (1068); Premature Separation (4045)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/20/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Based on the available information, this event is deemed to be a reportable malfunction.To date no additional information has been received.Should additional information become available, a follow-up report will be submitted.Fda registration number.Reporting site: 8021545.Manufacturing site: 8021545.
 
Event or Problem Description
It was reported that the patient reported infusion set came off after showering on (b)(6) 2026.
 
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Brand Name
INSET GUARD
Common Device Name
SET, ADMINISTRATION, INTRAVASCULAR
Manufacturer (Section D)
UNOMEDICAL A/S
aaholmvej 1 - 3
osted
lejre 4320
DA  4320
Manufacturer (Section G)
UNOMEDICAL A/S
aaholmvej 1 - 3
osted
lejre 4320
DA   4320
Manufacturer Contact
courtney smith
aaholmvej 1 - 3
osted
lejre 4320
DA   4320
6032470255
MDR Report Key24956225
Report Number8021545-2026-03784
Device Sequence Number13341133
Product Code FPA
UDI-Device Identifier05705244023109
UDI-Public05705244023109
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
K210544
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 03/26/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Model NumberMMT-443AJ
Device Lot Number6014991
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/26/2026
Initial Report FDA Received Date04/22/2026
Date Device Manufactured08/01/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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