FDA Adverse Event Injury Summary report: N

CLEO 90 INFUSION SET

MDR report key: 1033323 · Received April 23, 2008

Report

Report Number
2183502-2008-00102
Event Type
Injury
Date Received
April 23, 2008
Date of Event
March 21, 2008
Report Date
April 22, 2008
Manufacturer
SMITHS MEDICAL MD, (FORMERLY DELTEC, INC)
Product Code
FPA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
LAY USER/PATIENT

Narratives

Additional Manufacturer Narrative · 1

CUSTOMER HAS NOT YET RETURNED THE DEVICE TO THE MFR FOR DEVICE EVALUATION. WHEN AND IF DEVICE BECOMES AVAILABLE, AND IS RETURNED AND EVALUATED, THE MFR WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVALUATION.

Description of Event or Problem · 1

INFO WAS RECEIVED THAT REPORTED A PT WAS TREATED FOR INFECTION. REPORTEDLY, THE PT RECEIVED TOPICAL ANTIBIOTICS FROM HIS ENDOCRINOLOGIST TO TREAT A LOCALIZED INFECTION AT THE PT'S INSULIN SET INFUSION SITE. IT WAS REPORTED THAT THE PT ONLY USES HIS ABDOMEN FOR HIS SITES, CHANGES EVERY THREE DAYS, AND ALSO HAS TWIDDLER'S SYNDROME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CLEO 90 INFUSION SET SUBCUTANEOUS INFUSION SET FPA SMITHS MEDICAL MD, (FORMERLY DELTEC, INC) 21-7220 003X78

Patients

Seq Age Sex Outcome Treatment
1 13 YR Required Intervention