BEUDAMED
    FDA Adverse Event Death Summary report: N

    PUMP MMT-722NAB PRDGM INS V2.2 BL EN

    MDR report key: 1667341 · Received April 19, 2010

    Report

    Report Number
    2032227-2010-80946
    Event Type
    Death
    Date Received
    April 19, 2010
    Date of Event
    January 11, 2010
    Report Date
    April 1, 2010
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    LZG
    PMA / PMN Number
    P980022
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NOT APPLICABLE

    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

    THE CUSTOMER'S FATHER REPORTED THAT THE CUSTOMER PASSED AWAY AFTER SUFFERING A HYPOGLYCEMIC CEREBRAL INJURY. THE FATHER STATED THAT THE CUSTOMER WAS NOT WEARING THE INSULIN PUMP WHEN HE WAS FOUND. THE MOTHER KEPT THE INSULIN PUMP, AND THE FATHER HAS NO COMMUNICATION WITH HER. NOTHING FURTHER WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PUMP MMT-722NAB PRDGM INS V2.2 BL EN INFUSION PUMP LZG MEDTRONIC MINIMED MMT-722NAB

    Patients

    Seq Age Sex Outcome Treatment
    1 40 YR Hospitalization