FDA Adverse Event Malfunction Summary report: N

SENSOR ENLITE

MDR report key: 3942879 · Received July 17, 2014

Report

Report Number
2032227-2014-04434
Event Type
Malfunction
Date Received
July 17, 2014
Date of Event
June 16, 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
CA
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 THAT THE SENSORS ARE GIVING INACCURATE READINGS. HE STATED THAT WHEN THE SENSOR GLUCOSE READING WAS 90 MG/DL, THE BLOOD GLUCOSE READING WAS 230 MG/DL. AT THE TIME OF THE CALL THE BLOOD GLUCOSE READING WAS 116 MG/DL AND THE SENSOR GLUCOSE READING WAS 147 MG/DL. IT WAS DETERMINED THAT CUSTOMER WAS NOT FOLLOWING PROPER PROCEDURE AS HE WAS USING THE ENLITE SENSORS WITH A REVEL INSULIN PUMP. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
418908 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A

Patients

Seq Age Sex Outcome Treatment
1 87 YR