FDA Adverse Event Malfunction Summary report: N

INSULIN INFUSION PUMP

MDR report key: 3182739 · Received June 21, 2013

Report

Report Number
2032227-2013-02513
Event Type
Malfunction
Date Received
June 21, 2013
Date of Event
May 29, 2013
Report Date
May 29, 2013
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
Product Problem
Yes
Report Source
Manufacturer report
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

CALL RECEIVED REGARDING THE UNDER DELIVERY OF INSULIN. NO ALARMS ARE GIVEN. NOTHING FURTHER REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
283029 INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-XXX

Patients

Seq Age Sex Outcome Treatment
1