BEUDAMED
    FDA Adverse Event Death Summary report: N

    MEDTRONIC MINIMED PARADIGM INSULIN PUMP

    MDR report key: 1419348 · Received July 20, 2009

    Report

    Report Number
    MW5012050
    Event Type
    Death
    Date Received
    July 20, 2009
    Date of Event
    March 5, 2009
    Report Date
    July 20, 2009
    Manufacturer
    MEDTRONIC INC
    Product Code
    FPA
    Report Source
    Voluntary report
    Reporter Location
    CO, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RECALL ON MEDTRONICS "LOT 8" QUICK SET INFUSION RECALL. SUICIDE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC MINIMED PARADIGM INSULIN PUMP QUICK SET INFUSION SETS "LOT 8" FPA MEDTRONIC INC MMT-397 8200650

    Patients

    Seq Age Sex Outcome Treatment
    1 55 YR Death| S