FDA Adverse Event Malfunction Summary report: N

MINIMED MIO ADVANCE

MDR report key: 22432742 · Received July 8, 2025

Report

Report Number
8021545-2025-01725
Event Type
Malfunction
Date Received
July 8, 2025
Date of Event
June 22, 2025
Report Date
October 2, 2025
Manufacturer
UNOMEDICAL A/S
Product Code
FPA
UDI-DI
05705244018877
PMA / PMN Number
K173879
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

E1: PATIENT CITY: (B)(6). PATIENT COUNTRY: UNITED STATES.

Additional Manufacturer Narrative · 0

THE INITIAL MDR WITH MANUFACTURING REPORT NUMBER (8021545-2025-01725), WAS SUBMITTED ON 08-JUL-2025. UPON RECEIVING ADDITIONAL INFORMATION, IT WAS DISCOVERED THAT MANUFACTURING DATE HAS UPDATED TO 24-FEB-2025. ADDITIONAL INFORMATION - THIS MDR IS BEING SUBMITTED TO INCLUDE THE BELOW: H4: MANUFACTURING DATE. H6: INVESTIGATION RESULTS UNDER TYPE OF INVESTIGATION. H11: INVESTIGATION SUMMARY. COMPLAINT INVESTIGATION RESULTS: A COMPLAINT INVESTIGATION HAS BEEN INITIATED UNDER COMPLAINT INVESTIGATION CHILD RECORD (B)(4). THE BATCH 6011774 IN QUESTION WAS MANUFACTURED AT THE OSTED SITE. DEVICE HISTORY RECORD (DHR)REVIEW: THE LOT 6011774 WAS MANUFACTURED ACCORDING TO [80] APPENDIX 1 BATCHCARD FOR PRODUCTION OF PACKAGING ROOM ON 24-FEB-2025, WITH A TOTAL OF (B)(4) UNITS. REVIEW OF THE DHR SHOWED THAT ALL RELEVANT TESTS REQUIRED DURING THE RELATED PROCESSES HAD BEEN FULFILLED AND MET THE REQUIREMENTS. NO DEVIATION WAS IDENTIFIED, NOR MAINTENANCE EVENTS WERE RECORDED RELATED TO COMPLAINT CODE. TEST RESULTS: NO SAMPLE WAS PROVIDED. CONCLUSION SUMMARY OF COMPLAINT INVESTIGATION: AS A RESULT OF THE FOLLOWING: NO NON-CONFORMANCE (NC) RAISED DURING PRODUCTION RELATED TO COMPLAINT CODE, NO TREND IDENTIFIED, NO FURTHER ACTIONS ARE REQUIRED. THIS COMPLAINT WILL NOT REQUIRE FURTHER ROOT CAUSE INVESTIGATION NOR CORRECTIVE AND PREVENTIVE ACTION (CAPA) PLAN. THEREFORE, THIS ISSUE WILL BE MONITORED THROUGH THE POST MARKET SURVEILLANCE ACTIVITIES.

Description of Event or Problem · 0

REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT THE PATIENT FACED AN INFUSION SET TUBING DETACHED EVENT ON 22-JUN-2025 AT SITE LOACTION. INFUSION SET WAS USED FOR ONE DAY. THE INSERTION SITE WAS THE RIGHT ABDOMEN/LEFT ABDOMEN. NO FURTHER INFORMATION AVAILABLE.

Description of Event or Problem · 0

TO DATE, ADDITIONAL PATIENT OR EVENT DETAILS WERE RECEIVED WHICH HAVE BEEN ADDED IN H11.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1842958 MINIMED MIO ADVANCE UNO MIO ADV. GREY 60/6 SC1 10-PK INT FPA UNOMEDICAL A/S MMT-242A 6011774 05705244018877

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown