BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PUMP MMT-512LNAS PRDGM INS SK EN US LN

    MDR report key: 1031538 · Received April 18, 2008

    Report

    Report Number
    2032227-2008-00667
    Event Type
    Injury
    Date Received
    April 18, 2008
    Date of Event
    April 5, 2008
    Report Date
    April 5, 2008
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    LZG
    PMA / PMN Number
    K030531
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    CURRENTLY, IT IS UNK WHETHER OR NOT THE DEVICE MAY HAVE CAUSED OR CONTRIBUTED TO THE EVENT AS NO PRODUCT HAS BEEN RETURNED. WE, THEREFORE, CONSIDER THIS REPORT COMPLETE TO THE BEST OF OUR KNOWLEDGE. NO CONCLUSION CAN BE DRAWN AT THIS TIME.

    Description of Event or Problem · 1

    INITIALLY THE CUSTOMER CALLED FOR ASSISTANCE PROGRAMMING THE INSULIN PUMP. THE CUSTOMER WAS TAKEN TO THE EMERGENCY ROOM FOR TREATMENT BECAUSE HER BLOOD GLUCOSE DROPPED TO 25 MG/DL. THE CUSTOMER STATED THAT SHE DID NOT EAT ALL DAY BECAUSE SHE WAS TAKING PAIN PILLS AND WAS SLEEPING A LOT. THE CUSTOMER WAS ASSISTED WITH THE INSULIN PUMP PROGRAMMING. NOTHING FURTHER WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PUMP MMT-512LNAS PRDGM INS SK EN US LN INFUSION PUMP LZG MEDTRONIC MINIMED MMT-512LNAS

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention