BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PARADIGM REAL-TIME REVEL INSULIN INFUSION PUMP

    MDR report key: 3120209 · Received May 20, 2013

    Report

    Report Number
    2032227-2013-01856
    Event Type
    Injury
    Date Received
    May 20, 2013
    Date of Event
    April 15, 2013
    Report Date
    April 23, 2013
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    OYC
    PMA / PMN Number
    P980022
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    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. NO CONCLUSION CAN BE DRAWN AT THIS TIME. WE THEREFORE CONSIDER THIS REPORT COMPLETE TO THE BEST OF OUR KNOWLEDGE.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PARAMEDICS WERE CALLED TO ASSIST A CUSTOMER WITH LOW BLOOD GLUCOSE. CALLER STATED THAT THE BLOOD GLUCOSE READING WAS 60 MG/DL WHEN PARAMEDICS ARRIVED. CALLER STATED THAT IT WAS THE CUSTOMER'S FIRST DAY ON THE INSULIN PUMP AND THE SETTINGS WERE TOO HIGH FOR HER. NOTHING FURTHER WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    222705 PARADIGM REAL-TIME REVEL INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-723NAH

    Patients

    Seq Age Sex Outcome Treatment
    1 25 YR Required Intervention