FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 3133951 · Received May 29, 2013

Report

Report Number
2032227-2013-02187
Event Type
Malfunction
Date Received
May 29, 2013
Date of Event
April 26, 2013
Report Date
May 10, 2013
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

THE INSULIN PUMP WAS RECEIVED WITH FROZEN DISPLAY DUE TO CORROSION ON THE ELECTRONIC ASSEMBLY. BUTTONS FUNCTION PROPERLY WITH TESTING ELECTRONIC ASSEMBLY. NO MOISTURE DAMAGE FOUND ON THE KEYPAD TRACES. UNABLE TO PERFORMED THE ERROR ALARM DUE TO FROZEN DISPLAY.

Description of Event or Problem · 1

CUSTOMER REPORTED THAT THERE IS NO RESPONSE FROM ANY BUTTON ON THE INSULIN PUMP. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
235297 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-522LNAH

Patients

Seq Age Sex Outcome Treatment
1 56 YR