FDA Adverse Event Injury Summary report: N

PARADIGM INSULIN INFUSION PUMP

MDR report key: 2031047 · Received March 16, 2011

Report

Report Number
2032227-2011-00670
Event Type
Injury
Date Received
March 16, 2011
Date of Event
January 25, 2011
Report Date
March 1, 2011
Manufacturer
MEDTRONIC MINIMED
Product Code
MDS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
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 BEING HOSPITALIZED FOR DIABETIC KETOACIDOSIS, WITH BLOOD GLUCOSE LEVELS BETWEEN 700 AND 800 MG/DL. THE CUSTOMER STATED THAT SHE ALSO SUFFERED A HEART ATTACK DUE TO THE DIABETIC KETOACIDOSIS. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PARADIGM INSULIN INFUSION PUMP INSULIN INFUSION PUMP MDS MEDTRONIC MINIMED MMT-522LNAS

Patients

Seq Age Sex Outcome Treatment
1 68 YR Hospitalization