FDA Adverse Event Injury Summary report: N

XMTR MMT-7703NA MINILINK GST1 17L REPL

MDR report key: 1870128 · Received October 11, 2010

Report

Report Number
2032227-2010-82908
Event Type
Injury
Date Received
October 11, 2010
Date of Event
September 23, 2010
Report Date
September 23, 2010
Manufacturer
MEDTRONIC MINIMED
Product Code
MDS
PMA / PMN Number
P980022
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE MINILINK WAS UNABLE TO CHARGE DUE TO A SWOLLEN AND DEPLETED BATTERY.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT SHE WAS HOSPITALIZED FOR SEIZURES DUE TO HIGH AND LOW BLOOD GLUCOSE LEVELS. THE CUSTOMER STATED THAT HER BLOOD GLUCOSE LEVELS ARE ERRATIC DUE TO PANCREATIC FAILURE. THE CUSTOMER ALSO REPORTED THAT THE MINILINK IS NO LONGER CHARGING. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 XMTR MMT-7703NA MINILINK GST1 17L REPL TRANSMITTER MDS MEDTRONIC MINIMED MMT-7703NA

Patients

Seq Age Sex Outcome Treatment
1 40 YR Hospitalization