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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ANIMAS LLC ANIMAS VIBE; INSULIN INFUSION PUMP

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ANIMAS LLC ANIMAS VIBE; INSULIN INFUSION PUMP Back to Search Results
Medical Device Problem Codes Premature Discharge of Battery (1057); Structural Problem (2506)
Health Effect - Clinical Code No Consequences Or Impact To Patient (2199)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
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.
 
Event or Problem Description
On (b)(6) 2018, the reporter contacted animas, alleging that the pump had shorter than expected battery life.The reporter stated that the battery cap had a worn top.This complaint is being reported because the issue may result in a long-term cessation of insulin delivery if the user is unable to resolve the alarm.There was no allegation of an adverse event associated with this complaint.
 
Additional Manufacturer Narrative
Device evaluation: the device has been returned and evaluated by product analysis on 05-nov-2018 with the following findings: there were frequent low battery warnings observed in the pump history.The pump's electrical current draws were tested and were within specifications.There was corrosion found in the battery compartment, but nowhere else within the pump.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.
 
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Brand Name
ANIMAS VIBE
Common Device Name
INSULIN INFUSION PUMP
Manufacturer (Section D)
ANIMAS LLC
965 chesterbrook blvd
wayne PA 19087
MDR Report Key7901343
Report Number2531779-2018-17346
Device Sequence Number10805332
Product Code OYC
UDI-Device Identifier10840406103229
UDI-Public10840406103229
Combination Product (Y/N)Y
Initial Reporter StateWI
Initial Reporter CountryUS
PMA/510(K) Number
P130007
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source consumer
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 09/11/2018
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
Operator of Device Lay User/Patient
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/31/2018
Was the Report Sent to FDA? Yes
Device Age13 MO
Initial Date Received by Manufacturer 09/11/2018
Supplement Date Received by Manufacturer09/11/2018
Initial Report FDA Received Date09/24/2018
Supplement Report FDA Received Date11/12/2018
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Patient Age54 YR
Patient Weight262
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