MINIMED 780G US SYSTEM BLE CONNECT 3.0 MG/DL
Report
- Report Number
- 2032227-2026-173582
- Event Type
- Malfunction
- Date Received
- May 26, 2026
- Date of Event
- April 18, 2026
- Report Date
- May 13, 2026
- Manufacturer
- MEDTRONIC PUERTO RICO OPERATIONS CO.
- Product Code
- QJS
- UDI-DI
- 000076300096003201
- PMA / PMN Number
- P160017
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- WI, 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 ALLEGES THE PUMP IS OVER-DELIVERING. THE CUSTOMER REPORTED A BLOOD GLUCOSE VALUE OF 75 MG/DL .THE CUSTOMER EXPERIENCED HYPOGLYCEMIA AND WAS TREATED WITH A GLUCOSE TABLETS OR ORANGE JUICE. THE CUSTOMER EXPERIENCED A LOSS OF CONSCIOUSNESS, AND SEIZURE DUE TO THE SENSOR ISSUE THE EVENT INVOLVED PRODUCT(S) MMT-1884, MMT-332A, 78893-01, AND MMT-242A. TROUBLESHOOTING WAS PERFORMED FOR THE LOW BLOOD GLUCOSE. THE CUSTOMER HAS BEEN USING THE INSULIN PUMP SYSTEM WITHIN 48HOURS OF A REPORTED LOW BLOOD GLUCOSE EVENT. THE CUSTOMER WAS USING THE MINIMED 670G/770G/ 780G SYSTEM WITH THE AUTO MODE/SMARTGUARD FEATURE ACTIVE AT THE TIME OF A LOW BLOOD GLUCOSE EVENT. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED. NO PRODUCT RETURN IS REQUIRED FOR MMT-1884. THE CUSTOMER WAS INSTRUCTED TO DISCONTINUE DEVICE USE. MMT-332A, MMT-242A, AND 78893-01 WAS REQUESTED, AND THE CUSTOMER'S RESPONSE WAS THAT THE DEVICE WOULD BE RETURNED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 89299 | MINIMED 780G US SYSTEM BLE CONNECT 3.0 MG/DL | INTEROPERABLE AUTOMATED GLYCEMIC CONTROLLER, INSULIN SUSPEND | QJS | MEDTRONIC PUERTO RICO OPERATIONS CO. | MMT-1884 | NG4261383H | 000076300096003201 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |