FDA Adverse Event Injury Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 2031096 · Received March 16, 2011

Report

Report Number
2032227-2011-00658
Event Type
Injury
Date Received
March 16, 2011
Date of Event
February 26, 2011
Report Date
February 26, 2011
Manufacturer
MEDTRONIC MINIMED
Product Code
MDS
PMA / PMN Number
P980022
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

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.

Description of Event or Problem · 1

THE CUSTOMER INITIALLY CALLED FOR ASSISTANCE WITH THE BLOOD GLUCOSE METER COMMUNICATING WITH THE INSULIN PUMP. THE CUSTOMER ALSO MENTIONED THAT SHE WAS TREATED BY THE PARAMEDICS FOR LOW BLOOD GLUCOSE LEVELS. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP MDS MEDTRONIC MINIMED MMT-722LNAP

Patients

Seq Age Sex Outcome Treatment
1 49 YR Required Intervention