FDA Adverse Event
Injury
Summary report: N
PARADIGM REAL-TIME INSULIN INFUSION PUMP
MDR report key: 3200276
·
Received July 1, 2013
Report
- Report Number
- 2032227-2013-02667
- Event Type
- Injury
- Date Received
- July 1, 2013
- Date of Event
- November 29, 2012
- Report Date
- June 19, 2013
- Manufacturer
- MEDTRONIC MINIMED
- Product Code
- OYC
- PMA / PMN Number
- P980022
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OH
- 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
A PHONE CALL WAS MADE TO THE CUSTOMER IN ORDER TO FOLLOW UP ON A PREVIOUS CALL SHE HAD MADE FOR HIGH BLOOD GLUCOSE LEVELS. THE CUSTOMER STATED THAT SHE WENT TO THE EMERGENCY ROOM DUE TO DIABETIC KETOACIDOSIS. THE CUSTOMER DID NOT KNOW WHAT THE BLOOD GLUCOSE READING WAS AT THE TIME. THE CUSTOMER WAS TOLD THAT SHE HAD AN INFECTION THAT CONTRIBUTED TO THE ELEVATED BLOOD GLUCOSE LEVELS. NOTHING FURTHER WAS REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 298411 | PARADIGM REAL-TIME INSULIN INFUSION PUMP | INSULIN INFUSION PUMP / SENSOR AUGMENTED | OYC | MEDTRONIC MINIMED | MMT-722RNAL |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 69 YR | Hospitalization |