BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDTRONIC MINIMED

    MDR report key: 2344258 · Received November 15, 2011

    Report

    Report Number
    MW5023153
    Event Type
    Malfunction
    Date Received
    November 15, 2011
    Date of Event
    August 11, 2011
    Report Date
    November 15, 2011
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    MDS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    ND, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    TRANSMITTER IS OFF WARRANTY (B)(6) 2010. TRANSMITTER STOPPED WORKING. DATES OF USE: (B)(6) 2011.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC MINIMED REAL TIME TRANSMITTER MDS MEDTRONIC MINIMED KIT101845U

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR