FDA Adverse Event Malfunction Summary report: N

SENSOR ENLITE

MDR report key: 3945589 · Received July 21, 2014

Report

Report Number
2032227-2014-04521
Event Type
Malfunction
Date Received
July 21, 2014
Date of Event
June 18, 2014
Report Date
June 18, 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 SHE RECEIVED A CHANGE SENSOR ALERT. CUSTOMER STATED THAT THE ALERT OCCURRED AFTER TWO CONSECUTIVE CALIBRATION ERRORS AND AFTER INITIALIZATION. SENSOR AGE IS 4 DAYS AND 21 HOURS; INSERTED IN ABDOMEN. BLOOD GLUCOSE READING 129 MG/DL. NOTHING FURTHER REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
425071 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A

Patients

Seq Age Sex Outcome Treatment
1 45 YR