FDA Adverse Event
Malfunction
Summary report: N
SENSOR ENLITE
MDR report key: 3942907
·
Received July 17, 2014
Report
- Report Number
- 2032227-2014-04344
- 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
- MI
- 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 HER BLOOD GLUCOSE WAS 231 MG/DL. CUSTOMER STATED THAT HER SENSOR CANNULA WAS KINKED WHEN SHE REMOVED IT. CUSTOMER STATED THAT KINKED CANNULA HAPPENED WITH 3 DIFFERENT SENSORS. NOTHING FURTHER WAS REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 419675 | SENSOR ENLITE | OZO | OZO | MEDTRONIC MINIMED | MMT-7008A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 43 YR |