FDA Adverse Event Injury Summary report: N

INSULIN INFUSION PUMP

MDR report key: 3203435 · Received July 2, 2013

Report

Report Number
2032227-2013-02719
Event Type
Injury
Date Received
July 2, 2013
Date of Event
June 1, 2013
Report Date
June 9, 2013
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
Adverse Event
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

THE CUSTOMER POSTED ON (B)(4), THAT SHE SPENT THE WEEKEND IN THE ICU DUE TO BLOOD GLUCOSE LEVELS GREATER THAN 740 MG/DL. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
302632 INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-XXX

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization