MINIMED 780G US SYSTEM BLE CONNECT 3.0 MG/DL
Report
- Report Number
- 2032227-2026-172150
- Event Type
- Injury
- Date Received
- May 11, 2026
- Date of Event
- April 17, 2026
- Report Date
- May 10, 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
- ME, 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 EXPERIENCED HYPOGLYCEMIA, DIFFERENCES BETWEEN SENSOR GLUCOSE AND BLOOD GLUCOSE LEVELS AND THE INSULIN DELIVERY WAS SUSPENDED. THE CUSTOMER REPORTED BLOOD GLUCOSE VALUE OF 50 MG/DL. THE EVENT INVOLVED PRODUCT(S) MMT-1884, 78893-01, UNOMEDICAL, UNK_RESERVOIR. TROUBLESHOOTING WAS NOT PERFORMED FOR HYPOGLYCEMIA. IT WAS UNKNOWN WHETHER THE CUSTOMER WAS USING THE INSULIN PUMP WITHIN 48 HOURS OF THE REPORTED EVENT. THERE IS NO MENTION OF THE AUTO MODE FEATURE AT THE TIME OF THE EVENT. TROUBLESHOOTING WAS PERFORMED FOR DIFFERENCES IN GLUCOSE VALUES. THE CUSTOMER WAS REPORTING BLOOD GLUCOSE VALUE OF 159 MG/DL, SENSOR GLUCOSE VALUE OF 50 MG/DL AT THE TIME OF EVENT. THE CUSTOMER WAS ALSO REPORTED LOW LIMIT IN THE SENSOR SETTINGS WAS 70 MG/DL. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED. NO PRODUCT RETURN IS REQUIRED FOR MMT-1884, 78893-01, UNOMEDICAL, UNK_RESERVOIR.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 173650 | MINIMED 780G US SYSTEM BLE CONNECT 3.0 MG/DL | INTEROPERABLE AUTOMATED GLYCEMIC CONTROLLER, INSULIN SUSPEND | QJS | MEDTRONIC PUERTO RICO OPERATIONS CO. | MMT-1884 | NG4264440H | 000076300096003201 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |