FDA Adverse Event Malfunction Summary report: N

SENSOR ENLITE

MDR report key: 3974174 · Received August 1, 2014

Report

Report Number
2032227-2014-05224
Event Type
Malfunction
Date Received
August 1, 2014
Date of Event
July 2, 2014
Report Date
July 2, 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. 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 A DIFFERENCE BETWEEN HIS SENSOR GLUCOSE AND BLOOD GLUCOSE READING. THE SENSOR GLUCOSE READING WAS 88 MG/DL AND BLOOD GLUCOSE READING WAS 163 MG/DL. CUSTOMER WAS NOT ABLE TO UPLOAD THE READINGS. THE CUSTOMER CALIBRATED HIS SENSOR AND REPORTED HIS SENSOR GLUCOSE AND BLOOD GLUCOSE READINGS ARE TRENDING UP. HE STATES THAT HE RARELY HAS THIS PROBLEM. CUSTOMER HAS BEEN ADVISED THAT SENSOR MAY HAVE GOTTEN COMPRESSED OVERNIGHT. THE CUSTOMER ALSO STATED THAT HE BOLUSED OFF THE SENSOR OVERNIGHT. CUSTOMER HAS BEEN ADVISED NEVER TO BOLUS OR TREAT OFF THE SENSOR READING. NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
450132 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A

Patients

Seq Age Sex Outcome Treatment
1 75 YR