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 |