FDA Adverse Event Injury Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 2090939 · Received May 2, 2011

Report

Report Number
2032227-2011-01115
Event Type
Injury
Date Received
May 2, 2011
Date of Event
April 22, 2011
Report Date
April 22, 2011
Manufacturer
MEDTRONIC MINIMED
Product Code
MDS
PMA / PMN Number
P980022
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AL, 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 REPORTED THAT SHE WAS TREATED BY THE PARAMEDICS DUE TO A LOW BLOOD GLUCOSE READING OF 20 MG/DL. THE CUSTOMER STATED THAT HER GLUCOSE METER WAS GIVING INCORRECT READINGS. THE CUSTOMER WAS TREATING WHAT SHE THOUGHT WERE HIGH BLOOD GLUCOSE LEVELS. FOUND THAT THE CUSTOMER WAS USING TEST STRIPS THAT HAD BEEN EXPIRED FOR TWO YEARS. 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-522LNAS

Patients

Seq Age Sex Outcome Treatment
1 36 YR Hospitalization