FDA Adverse Event Injury Summary report: N

MINIMED 780G US SYSTEM BLE CONNECT 3.0 MG/DL

MDR report key: 25290941 · Received May 26, 2026

Report

Report Number
2032227-2026-176060
Event Type
Injury
Date Received
May 26, 2026
Date of Event
April 3, 2026
Report Date
May 18, 2026
Manufacturer
MEDTRONIC PUERTO RICO OPERATIONS CO.
Product Code
QJI
PMA / PMN Number
P160017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

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.

Description of Event or Problem · 0

IT WAS REPORTED TO MEDTRONIC MINIMED THAT THE CUSTOMER EXPERIENCED HYPERGLYCEMIA. BLOOD GLUCOSE VALUE AT THE TIME OF EVENT WAS 760 MG/DL. THE CUSTOMER WAS TREATED WITH EMERGENCY ROOM VISIT. THE EVENT INVOLVED PRODUCT(S) MMT-1884, UNK_RESERVOIR, UNOMEDICAL. TROUBLESHOOTING WAS PARTIALLY PERFORMED. IT IS UNKNOWN WHETHER THE CUSTOMER WAS USING THE AUTO MODE/SMART GUARD FEATURE AT THE TIME OF THE EVENT. THE CUSTOMER WAS NOT USING THE INSULIN PUMP SYSTEM WITHIN 48 HOURS OF REPORTED EVENT. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED. NO PRODUCT RETURN IS REQUIRED FOR MMT-1884. NO PRODUCT RETURN IS REQUIRED FOR UNK_RESERVOIR. NO PRODUCT RETURN IS REQUIRED FOR UNOMEDICAL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
339869 MINIMED 780G US SYSTEM BLE CONNECT 3.0 MG/DL INTEROPERABLE AUTOMATED GLYCEMIC CONTROLLER QJI MEDTRONIC PUERTO RICO OPERATIONS CO. MMT-1884 NG4261003H

Patients

Seq Age Sex Outcome Treatment
1