FDA Adverse Event Malfunction Summary report: N

INPEN

MDR report key: 11874157 · Received May 25, 2021

Report

Report Number
3012822846-2021-00239
Event Type
Malfunction
Date Received
May 25, 2021
Date of Event
May 13, 2020
Report Date
May 24, 2021
Manufacturer
COMPANION MEDICAL INC
Product Code
FMF
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

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. WE THEREFORE CONSIDER THIS REPORT COMPLETE TO THE BEST OF OUR KNOWLEDGE. THIS MDR IS RELATED TO THE RETROSPECTIVE REVIEW OF COMPLAINTS FROM COMPANION MEDICAL INC, FOLLOWING MEDTRONIC¿S ACQUISITION OF THE COMPANY IN SEPTEMBER 2020.

Description of Event or Problem · 1

CUSTOMER REPORTED VIA PHONE CALL THAT SOMETIMES THEY DO NOT GET ANY DOSE DELIVERED. NO FURTHER DETAILS WERE PROVIDED. NO HARM REQUIRING MEDICAL INTERVENTION WAS REPORTED. THE DEVICE WAS NOT RETURNED FOR ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
778417 INPEN INPEN FMF COMPANION MEDICAL INC MMT-XXX

Patients

Seq Age Sex Outcome Treatment
1