FDA Adverse Event
Malfunction
Summary report: N
SENSOR ENLITE
MDR report key: 3933471
·
Received July 14, 2014
Report
- Report Number
- 2032227-2014-03796
- Event Type
- Malfunction
- Date Received
- July 14, 2014
- Date of Event
- June 11, 2014
- Report Date
- June 11, 2014
- Manufacturer
- MEDTRONIC MINIMED
- Product Code
- OZO
- PMA / PMN Number
- 120010
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IN
- 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
CUSTOMER REPORTED HE IS RECEIVING WEAK SIGNAL ALERTS THROUGHOUT THE DAY BUT HE NOTICES IT USUALLY HAPPENS WHEN SENSOR AND INSULIN PUMP ARE PLACED ON OPPOSITE SIDES OF HIS BODY. CUSTOMER ALSO REPORTED THAT HE EXPERIENCED LOW BLOOD GLUCOSE BUT SENSOR GLUCOSE WAS READING A HIGHER VALUE WHICH IS WHY HIS INSULIN PUMP DID NOT ALERTED HIM. BLOOD GLUCOSE VALUE IS UNKNOWN. NOTHING FURTHER REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 410983 | SENSOR ENLITE | OZO | OZO | MEDTRONIC MINIMED | MMT-7008A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 49 YR |