FDA Adverse Event
Malfunction
Summary report: N
PUMP MMT-722LNAB PRDGM INS BL EN ML
MDR report key: 1935094
·
Received December 6, 2010
Report
- Report Number
- 2032227-2010-83353
- Event Type
- Malfunction
- Date Received
- December 6, 2010
- Date of Event
- November 17, 2010
- Report Date
- November 17, 2010
- Manufacturer
- MEDTRONIC MINIMED
- Product Code
- MDS
- PMA / PMN Number
- P980022
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OH, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
THE INSULIN PUMP HAD A FROZEN SCREEN DURING THE INITIATION COUNT UP DUE TO A PROBLEM WITH THE MOTHER BOARD. UNABLE TO PERFORM FURTHER TESTING DUE TO THE FROZEN SCREEN.
Description of Event or Problem · 1
THE CUSTOMER REPORTED THAT THE INSULIN PUMP SCREEN APPEARS TO BE CHANGING FONTS. THE CUSTOMER ALSO STATED THAT THE SCREEN FREEZES AT TIMES. ADVISED THAT THE INSULIN PUMP WOULD BE REPLACED. NOTHING FURTHER WAS REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PUMP MMT-722LNAB PRDGM INS BL EN ML | INFUSION PUMP | MDS | MEDTRONIC MINIMED | MMT-722LNAB |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 46 YR |