FDA Adverse Event Injury Summary report: N

SENSOR, MMT-7002C, 10PK, GLUCOSE , BSA, 17L

MDR report key: 1812323 · Received August 20, 2010

Report

Report Number
2032227-2010-82393
Event Type
Injury
Date Received
August 20, 2010
Date of Event
July 12, 2010
Report Date
July 28, 2010
Manufacturer
MEDTRONIC MINIMED
Product Code
MDS
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 REPORTED, VIA EMAIL, THAT WHEN REMOVING THE SENSOR FROM THE INSERTION SITE, THE ACTUAL CATHETER STAYED INSIDE THE SKIN. THE CUSTOMER WENT TO THE EMERGENCY ROOM, BUT THEY WERE UNABLE TO DETECT IT WITH AN XRAY. THE CUSTOMER WILL BE SCHEDULED FOR AN MRI OR CT SCAN. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SENSOR, MMT-7002C, 10PK, GLUCOSE , BSA, 17L GLUCOSE SENSOR MDS MEDTRONIC MINIMED MMT-7002C

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization