FDA Adverse Event Malfunction Summary report: N

SENSOR MMT-7020D1 GUARDIAN SN3 1PK OUS1

MDR report key: 22801254 · Received August 13, 2025

Report

Report Number
2032227-2025-235241
Event Type
Malfunction
Date Received
August 13, 2025
Date of Event
October 28, 2023
Report Date
August 13, 2025
Manufacturer
MEDTRONIC MINIMED
Product Code
OZP
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUBMITTED AS PART OF A RETROSPECTIVE REVIEW PER CAPA 686868. SELECT PATIENT INFORMATION CANNOT BE PROVIDED DUE TO REGIONAL PRIVACY REGULATIONS. THE REPORTED DEVICE IS NOT MARKETED IN THE UNITED STATES, BUT IT IS A SAME/SIMILAR DEVICE TO ONE THAT IS MARKETED INSIDE THE UNITED STATES. 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. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE CUSTOMER EXPERIENCED SENSOR GLUCOSE VS. BLOOD GLUCOSE. BLOOD GLUCOSE VALUE WAS 103 MG/DL WHILE SENSOR GLUCOSE VALUE WAS 200 MG/DL. THE CUSTOMER REPORTED NO ADVERSE EVENT. THE EVENT INVOLVED PRODUCT(S) MMT-7020D1. THE SENSOR WAS WORN FOR 2-3 DAYS. CUSTOMER DECLINED TO REVIEW. USER STATED THEY HAD ALREADY LOST 3 SENSORS BECAUSE OF THE SG V BG ISSUES. CUSTOMER WAS ADVISED SENSOR MAY NO LONGER BE RESPONDING TO GLUCOSE CHANGES, MOST LIKELY DUE TO A SENSOR NOT SITUATED PROPERLY IN THE ISF PREVENTING SENSOR FROM PROPERLY TRACKING CHANGES IN GLUCOSE AND MAY ALSO BE RELATED TO SITE LOCATION/ROTATION, INSERTION TECHNIQUE OR TAPE TYPE/TECHNIQUE. NO PRODUCT RETURN IS EXPECTED FOR MMT-7020D1.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1392962 SENSOR MMT-7020D1 GUARDIAN SN3 1PK OUS1 AUTOMATED INSULIN DOSING DEVICE SYSTEM, SINGLE HORMONAL CONTROL OZP MEDTRONIC MINIMED MMT-7020D1

Patients

Seq Age Sex Outcome Treatment
1 32 YR Unknown