BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PRODUCT UNKNOWN

    MDR report key: 1081860 · Received July 23, 2008

    Report

    Report Number
    2032227-2008-01276
    Event Type
    Injury
    Date Received
    July 23, 2008
    Date of Event
    July 11, 2008
    Report Date
    July 11, 2008
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    LZG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NURSE

    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. NO CONCLUSION CAN BE DRAWN AT THIS TIME. WE, THEREFORE, CONSIDER THIS REPORT COMPLETE TO THE BEST OF OUR KNOWLEDGE.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE CUSTOMER WAS HOSPITALIZED, DUE TO DIABETIC KETOACIDOSIS. THE RPTR REFUSED TO SUPPLY ANY CUSTOMER INFO, ONLY THAT THE CUSTOMER'S INSULIN PUMP WAS LOST WHILE AT THE HOSP. NOTHING FURTHER WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRODUCT UNKNOWN INSULIN PUMP LZG MEDTRONIC MINIMED MMT-511

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization