FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 3073662 · Received April 23, 2013

Report

Report Number
2032227-2013-01495
Event Type
Malfunction
Date Received
April 23, 2013
Date of Event
April 20, 2013
Report Date
April 20, 2013
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INSULIN PUMP RECEIVED WITH BUTTON ERROR ALARM DUE TO CORRODED KEYPAD TRACES. A SCRATCHED LCD WINDOW, CRACKED CASE AND CRACKED RESERVOIR TUBE LIP WAS ALSO NOTED.

Additional Manufacturer Narrative · 1

CURRENTLY IT IS UNKNOWN WHETHER OR NOT THE DEVICE MAY HAVE CAUSED OR CONTRIBUTED TO THE EVENT AS NO PRODUCT HAS BEEN RETURNED. THE DEVICE WILL BE RETURNED FOR ANALYSIS AND FURTHER INFORMATION WILL FOLLOW ONCE THE ANALYSIS HAS BEEN COMPLETED. NO CONCLUSION CAN BE DRAWN AT THIS TIME.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE INSULIN PUMP GAVE A BUTTON ERROR ALARM, BUT THE CUSTOMER COULD NOT CLEAR IT DUE TO UNRESPONSIVE BUTTONS. THE REPORTED BLOOD GLUCOSE READING WAS 6.0 MMOL/L. IT WAS STATED THAT THE CUSTOMER WAS SLEEPING AT THE TIME OF THE ALARM, AND MAY HAVE BEEN PRESSING ON THE BUTTONS, BUT ISN'T SURE. IT WAS ALSO STATED THAT THE TIME ON THE SCREEN WAS STUCK ON 12:21, AND HAD NOT CHANGED. ADVISED THAT THE INSULIN PUMP WOULD BE REPLACED DUE TO THE FROZEN DISPLAY. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
174413 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-522LWWL

Patients

Seq Age Sex Outcome Treatment
1