FDA Adverse Event Malfunction Summary report: N

TRANSMITTER MMT-7841ZN GST5G US

MDR report key: 19535145 · Received June 14, 2024

Report

Report Number
2032227-2024-186620
Event Type
Malfunction
Date Received
June 14, 2024
Date of Event
May 24, 2024
Report Date
June 13, 2024
Manufacturer
MEDTRONIC MINIMED
Product Code
PQF
PMA / PMN Number
P160017
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
003

Narratives

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 SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF 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. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Description of Event or Problem · 0

IT WAS REPORTED TO MEDTRONIC MINIMED THAT THE CUSTOMER EXPERIENCED CUSTOMER REPORTED A LOSS OF COMMUNICATION BETWEEN THE TRANSMITTER AND THE PUMP, CHARGE/BATTERY LASTS LESS THAN EXPECTED, LOST SENSOR ALARM. THE EVENT INVOLVED PRODUCT(S) MMT-7841ZN, MMT-1884, MMT-7040A. TROUBLE SHOOTING WAS NOT PERFORMED AND CUSTOMER REPORTED A LOSS OF COMMUNICATION BETWEEN THE TRANSMITTER AND THE PUMP. CUSTOMER REPORTED THE TRANSMITTER BATTERY WAS NOT LASTING AS LONG AS EXPECTED. NO HARM REQUIRING MEDICAL INTERVENTION WAS REPORTED. PRODUCT RETURN REQUESTED FOR MMT-7841ZN. CUSTOMER DECLINED TO RETURN, OR IS UNABLE TO RETURN. NO PRODUCT RETURN IS REQUIRED FOR MMT-1884. NO PRODUCT RETURN IS REQUIRED FOR MMT-7040A.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
157793 TRANSMITTER MMT-7841ZN GST5G US SENSOR, GLUCOSE, INVASIVE , NON-ADJUNCTIVE PQF MEDTRONIC MINIMED MMT-7841ZN 1114174

Patients

Seq Age Sex Outcome Treatment
1 51 YR Male