FDA Adverse Event Malfunction Summary report: N

MINIMED 780G US SYSTEM BLE CONNECT 3.0 MG/DL

MDR report key: 25313002 · Received May 28, 2026

Report

Report Number
2032227-2026-181362
Event Type
Malfunction
Date Received
May 28, 2026
Date of Event
May 8, 2026
Report Date
May 28, 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
HI, 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 MINIMED THAT THE CUSTOMER EXPERIENCED BLEEDING ON SITE AND OBSERVED A DISCREPANCY IN READING BETWEEN SENSOR GLUCOSE AND BLOOD GLUCOSE VALUES. THE CUSTOMER ALSO REPORTED A LOSS OF COMMUNICATION BETWEEN PUMP AND MOBILE. THE EVENT INVOLVED PRODUCT(S) MMT-6102, MMT-7040A, MMT-1884. TROUBLESHOOTING WAS PERFORMED AND A DISCREPANCY IN READING BETWEEN SENSOR GLUCOSE OF 89 MG/DL AND BLOOD GLUCOSE VALUES OF 135 MG/DL AND INSULIN DELIVERY WAS SUSPENDED. REPORTED ISSUE RESOLVED, NO ESCALATION REQUIRED FOR COMMUNICATION ISSUE. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED. THE PRODUCTS MMT-7040A, MMT-1884 WILL NOT BE RETURNED FOR ANALYSIS. A PRODUCT RETURN IS NOT APPLICABLE FOR NON PHYSICAL DEVICES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
522105 MINIMED 780G US SYSTEM BLE CONNECT 3.0 MG/DL INTEROPERABLE AUTOMATED GLYCEMIC CONTROLLER, INSULIN SUSPEND QJS MEDTRONIC PUERTO RICO OPERATIONS CO. MMT-1884 NG4168198H 000076300096003201

Patients

Seq Age Sex Outcome Treatment
1