MINIMED 780G US SYSTEM BLE CONNECT 3.0 MG/DL
Report
- Report Number
- 2032227-2026-171433
- Event Type
- Injury
- Date Received
- May 8, 2026
- Date of Event
- April 18, 2026
- Report Date
- May 7, 2026
- Manufacturer
- MEDTRONIC PUERTO RICO OPERATIONS CO.
- Product Code
- QJS
- UDI-DI
- 000076300096003201
- PMA / PMN Number
- P160017
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- WA, US
- Reporter Occupation
- 003
Narratives
THIS MDR RELATED TO THE PUERTO RICO MANUFACTURING SITE HAS BEEN ASSIGNED A MEDWATCH NUMBER FROM THE MEDTRONIC MINIMED NORTHRIDGE SITE, PER VARIANCE 5. 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. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.
IT WAS REPORTED TO MEDTRONIC MINIMED THAT THE CUSTOMER RECEIVED A CHANGE SENSOR, AND SENSOR UPDATING ALERT. THE CUSTOMER REPORTED A BLOOD GLUCOSE VALUE OF 342 MG/DL. THE CUSTOMER EXPERIENCED HYPERGLYCEMIA AND WAS TREATED WITH AN IV INSULIN DRIP (INTRAVENOUS INSULIN INFUSION). THE EVENT INVOLVED PRODUCT(S) MMT-332A, MMT-213A, MMT-7040B, AND MMT-1884. TROUBLESHOOTING WAS PERFORMED FOR THE CHANGE SENSOR ALERT, AND THE CUSTOMER IS UNABLE TO RUN A TRANSMITTER TEST AND/OR TEST PASSED. TROUBLESHOOTING WAS PARTIALLY PERFORMED FOR THE HIGH BLOOD GLUCOSE. IT WAS UNKNOWN WHETHER THE CUSTOMER WAS USING THE PUMP WITHIN 48 HOURS BEFORE THE EVENT AND WHETHER THE AUTO MODE FEATURE WAS ACTIVE OR NOT AT THE TIME OF THE EVENT NO FURTHER PATIENT COMPLICATIONS WERE REPORTED. NO PRODUCT RETURN IS REQUIRED FOR MMT-332A, MMT-213A, MMT-7040B, AND MMT-1884.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 280370 | MINIMED 780G US SYSTEM BLE CONNECT 3.0 MG/DL | INTEROPERABLE AUTOMATED GLYCEMIC CONTROLLER, INSULIN SUSPEND | QJS | MEDTRONIC PUERTO RICO OPERATIONS CO. | MMT-1884 | NG4290445H | 000076300096003201 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 70 YR | Female | Other | FRN-MMT-332A-RSVR, UNOMED INF SET.| OZP-MMT-7040B-SNSR. |