BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MINIMED INFUSION PUMP

    MDR report key: 313117 · Received January 18, 2001

    Report

    Report Number
    2025512-2000-00260
    Event Type
    Malfunction
    Date Received
    January 18, 2001
    Date of Event
    November 12, 2000
    Report Date
    November 12, 2000
    Manufacturer
    MINI MED INC.
    Product Code
    LZG
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    CUSTOMER'S FAMILY MEMBER CALLED TO REPORT THE DRIVER ARMS ON THE PT'S PUMP FELL OFF. DEVICE WAS NOT DROPPED, BUMPED, OR EXPOSED TO MOISTURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2439 MINIMED INFUSION PUMP INFUSION PUMP LZG MINI MED INC. MMT-507CUC NA

    Patients

    Seq Age Sex Outcome Treatment
    1 18 YR