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