FDA Adverse Event Malfunction Summary report: N

SMARTPHONE ANDROID APP: PUMP CONNECT

MDR report key: 16082579 · Received January 2, 2023

Report

Report Number
2032227-2023-100857
Event Type
Malfunction
Date Received
January 2, 2023
Date of Event
December 23, 2022
Report Date
March 27, 2023
Manufacturer
MEDTRONIC MINIMED
Product Code
PKU
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

ANALYSIS SUMMARY: AN ATTEMPT TO REPRODUCE THE REPORTED EVENT USING: MINIMED MOBILE APP (SOFTWARE VERSION 1.3.1) INSTALLED ON DEVICE GALAXY S21 5G, ANDROID 12 WITH 780G MMT-1885 PUMP (SOFTWARE VERSION 6.7V) WAS MADE. THE ISSUE WAS NOT REPRODUCED. APPLICATION LOGS SPANNING FROM 03-OCT-22 TO 01-DEC-22 WERE ANALYZED. THE PUMP-APP DISCONNECTION SEQUENCE WAS OBSERVED THROUGHOUT THE ATTACHED LOGS. SOFTWARE PERFORMED AS EXPECTED PER BLE CONNECT IOS AND ANDROID MOBILE *SOFTWARE REQUIREMENTS SPECIFICATIONS - D00780504.* THE REASON FOR LOST CONNECTION WAS THE PUMP DISCONNECTING THE PHONE (GATT SERVER DISCONNECTING GATT CLIENT) WITH ERROR CODE 0. IT WAS SUSPECTED THAT THIS ISSUE COULD HAVE BEEN CAUSED AS THE USER MIGHT HAVE CONFLICTING APPS USING BLUETOOTH AKA FITBIT ISSUE (FITBIT/KAROO). FURTHER ANALYSIS OF PUMP TRACES WOULD BE REQUIRED TO CONFIRM THE SAME. THE HELPLINE WAS PROVIDED THE INFORMATION AND REQUEST FOR PUMP LOGS WERE MADE. HOWEVER, THE CUSTOMER DID NOT RESPOND AND THE COMMUNICATION WAS LOST. MEDTRONIC, INC. (MEDTRONIC) IS SUBMITTING THIS REPORT TO COMPLY WITH 21 C.F.R. PART 803, THE MEDICAL DEVICE REPORTING REGULATION. THIS REPORT IS BASED UPON INFORMATION OBTAINED BY MEDTRONIC, WHICH THE COMPANY MAY NOT HAVE BEEN ABLE TO FULLY INVESTIGATE OR VERIFY PRIOR TO THE DATE THE REPORT WAS REQUIRED BY THE FDA. MEDTRONIC HAS MADE REASONABLE EFFORTS TO OBTAIN MORE COMPLETE INFORMATION IN THE TIME ALLOTTED AND HAS PROVIDED AS MUCH INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. IN PARTICULAR, THIS REPORT DOES NOT CONSTITUTE AN ADMISSION BY ANYONE THAT THE PRODUCT DESCRIBED IN THIS REPORT HAS ANY "DEFECTS" OR HAS "MALFUNCTIONED". THESE WORDS ARE INCLUDED IN THE FDA 3500A FORM AND ARE FIXED ITEMS FOR SELECTION CREATED BY THE FDA, TO CATEGORIZE THE TYPE OF EVENT SOLELY FOR THE PURPOSE OF REPORTING PURSUANT TO PART 803. MEDTRONIC OBJECTS TO THE USE OF THESE WORDS AND OTHERS LIKE IT BECAUSE OF THE LACK OF DEFINITION AND THE CONNOTATIONS IMPLIED BY THESE TERMS. THIS STATEMENT SHOULD BE INCLUDED WITH ANY INFORMATION OR REPORT DISCLOSED TO THE PUBLIC UNDER THE FREEDOM OF INFORMATION ACT.

Additional Manufacturer Narrative · 0

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. MEDTRONIC, INC. (MEDTRONIC) IS SUBMITTING THIS REPORT TO COMPLY WITH 21 C.F.R. PART 803, THE MEDICAL DEVICE REPORTING REGULATION. THIS REPORT IS BASED UPON INFORMATION OBTAINED BY MEDTRONIC, WHICH THE COMPANY MAY NOT HAVE BEEN ABLE TO FULLY INVESTIGATE OR VERIFY PRIOR TO THE DATE THE REPORT WAS REQUIRED BY THE FDA. MEDTRONIC HAS MADE REASONABLE EFFORTS TO OBTAIN MORE COMPLETE INFORMATION IN THE TIME ALLOTTED AND HAS PROVIDED AS MUCH INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. IN PARTICULAR, THIS REPORT DOES NOT CONSTITUTE AN ADMISSION BY ANYONE THAT THE PRODUCT DESCRIBED IN THIS REPORT HAS ANY "DEFECTS" OR HAS "MALFUNCTIONED". THESE WORDS ARE INCLUDED IN THE FDA 3500A FORM AND ARE FIXED ITEMS FOR SELECTION CREATED BY THE FDA, TO CATEGORIZE THE TYPE OF EVENT SOLELY FOR THE PURPOSE OF REPORTING PURSUANT TO PART 803. MEDTRONIC OBJECTS TO THE USE OF THESE WORDS AND OTHERS LIKE IT BECAUSE OF THE LACK OF DEFINITION AND THE CONNOTATIONS IMPLIED BY THESE TERMS. THIS STATEMENT SHOULD BE INCLUDED WITH ANY INFORMATION OR REPORT DISCLOSED TO THE PUBLIC UNDER THE FREEDOM OF INFORMATION ACT.

Description of Event or Problem · 0

INFORMATION RECEIVED BY MEDTRONIC INDICATED THAT THE CUSTOMER'S MINIMED MOBILE APP IS NOT SUPPORTING. TROUBLESHOOTING WAS PERFORMED AND ISSUE WAS NOT RESOLVED. NO HARM REQUIRING MEDICAL INTERVENTION WAS REPORTED. IT WAS UNKNOWN WHETHER THE CUSTOMER WILL CONTINUE USING THE DEVICE. THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2304720 SMARTPHONE ANDROID APP: PUMP CONNECT INSULIN PUMP SECONDARY DISPLAY PKU MEDTRONIC MINIMED MMT-6101

Patients

Seq Age Sex Outcome Treatment
1 Unknown