FDA Adverse Event Injury Summary report: N

SENSOR ENLITE

MDR report key: 3900896 · Received June 27, 2014

Report

Report Number
2032227-2014-03402
Event Type
Injury
Date Received
June 27, 2014
Date of Event
May 30, 2014
Report Date
May 30, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OZO
PMA / PMN Number
120010
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

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

IT WAS REPORTED THAT THE CUSTOMER WAS HOSPITALIZED DUE TO LOW BLOOD GLUCOSE. CALLER STATED THAT THE CUSTOMER'S BLOOD GLUCOSE READING WAS 33 MG/DL AT THE TIME OF ADMISSION. CALLER STATED THAT THE CUSTOMER'S SENSOR WAS GIVING INCORRECT READING AND CUSTOMER WAS TREATING BY THE SENSOR. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
376731 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008B

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization