BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SENSOR ENLITE

    MDR report key: 3942747 · Received July 17, 2014

    Report

    Report Number
    2032227-2014-03971
    Event Type
    Malfunction
    Date Received
    July 17, 2014
    Date of Event
    June 17, 2014
    Report Date
    June 17, 2014
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    OZO
    PMA / PMN Number
    120010
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY
    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. THE DEVICE WILL BE RETURNED FOR ANALYSIS AND FURTHER INFORMATION WILL FOLLOW ONCE THE ANALYSIS HAS BEEN COMPLETED. NO CONCLUSION CAN BE DRAWN AT THIS TIME.

    Description of Event or Problem · 1

    THE SENSOR IS ALERTING CHANGE SENSOR AFTER ONE DAY OF USE. THE BLOOD GLUCOSE READING IS 204 MG/DL. DURING TROUBLESHOOTING, REVIEWED THE INSERTION TECHNIQUE. CUSTOMER IS USING THE ABDOMEN AND SERTER. THE BLOOD GLUCOSE HAS INCREASED TO 329 MG/DL. SHE HAD EXPERIENCED A LOW OF 45 MG/DL. THE BAD SENSOR ALERT OCCURRED AFTER THE SECOND CONSECUTIVE CALIBRATION ERROR. THE CUSTOMER WILL REMOVE AND CHANGE THE SENSOR. NOTHING FURTHER REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    420663 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A

    Patients

    Seq Age Sex Outcome Treatment
    1 56 YR