FDA Adverse Event Malfunction Summary report: N

PUMP MMT-508GB EA INSULIN BL DE

MDR report key: 1070383 · Received June 30, 2008

Report

Report Number
2032227-2008-01091
Event Type
Malfunction
Date Received
June 30, 2008
Date of Event
June 6, 2008
Report Date
June 10, 2008
Manufacturer
MEDTRONIC MINIMED
Product Code
LZG
PMA / PMN Number
K990801
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

CURRENTLY IT IS UNKNOWN WHETHER OR NOT THE DEVICE MAY HAVE CAUSED OR CONTRIBUTED TO THE EVENT AS NO PRODUCT HAS BEEN RETURNED. NO CONCLUSION CAN BE DRAWN AT THIS TIME. THE DEVICE WILL BE RETURNED FOR ANALYSIS AND FURTHER INFORMATION WILL FOLLOW ONCE THE ANALYSIS HAS BEEN COMPLETED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE INSULIN PUMP FAILED THE HIGH-PRESSURE TEST. NO BLOOD GLUCOSE READING WAS REPORTED. NO FURTHER INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PUMP MMT-508GB EA INSULIN BL DE INFUSION PUMP LZG MEDTRONIC MINIMED MMT-508GB

Patients

Seq Age Sex Outcome Treatment
1