BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PARADIGM REAL-TIME INSULIN INFUSION PUMP

    MDR report key: 3171122 · Received June 14, 2013

    Report

    Report Number
    2032227-2013-02443
    Event Type
    Injury
    Date Received
    June 14, 2013
    Date of Event
    June 11, 2013
    Report Date
    June 11, 2013
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    OYC
    PMA / PMN Number
    P980022
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL
    Reporter Occupation
    PATIENT

    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

    THE CUSTOMER WAS CONTACTED IN ORDER TO FOLLOW UP ON A CALL THAT SHE HAD PLACED FOR HIGH BLOOD GLUCOSE LEVELS PREVIOUSLY. FOUND THAT THE CUSTOMER HAD RECENTLY GONE TO THE EMERGENY ROOM DUE TO HIGH BLOOD GLUCOSE LEVELS. THE CUSTOMER STATED THAT SHE WAS TOLD HER INSULIN WAS EXPIRED, AND SHE WAS PRESCRIBED NEW INSULIN. THE CUSTOMER DECLINED TROUBLESHOOTING ON THE INSULIN PUMP. NOTHING FURTHER WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    270947 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-522LNAL

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Hospitalization