FDA Adverse Event Malfunction Summary report: N

SENSOR ENLITE

MDR report key: 3930827 · Received July 12, 2014

Report

Report Number
2032227-2014-03581
Event Type
Malfunction
Date Received
July 12, 2014
Date of Event
June 12, 2014
Report Date
June 12, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OZO
PMA / PMN Number
120010
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA
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

IT WAS REPORTED THAT THE SENSORS ALERTED CALIBRATION ERROR AND CHANGE SENSOR ALARM. THE BLOOD GLUCOSE READING IS 256 MG/DL. THE SENSORS WILL BE REPLACED. NOTHING FURTHER REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
408700 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A HG023KY

Patients

Seq Age Sex Outcome Treatment
1 28 YR