BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    530G INSULIN PUMP MMT-751NAH

    MDR report key: 3974288 · Received August 1, 2014

    Report

    Report Number
    3004209178-2014-89145
    Event Type
    Malfunction
    Date Received
    August 1, 2014
    Date of Event
    July 3, 2014
    Report Date
    July 3, 2014
    Manufacturer
    MEDTRONIC PUERTO RICO OPERATIONS CO.
    Product Code
    OZO
    PMA / PMN Number
    P120010
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN
    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 METER WENT THROUGH BATTERIES QUICKLY. CUSTOMER REPORTED THAT SHE DID NOT WEAR A SENSOR DUE TO THE BEEPING AND FALSE PREDICTIVE LOW ALERTS. CUSTOMER ONLY CALIBRATED TWICE A DAY AND WAS ADVISED TO CALIBRATE 3-4 TIMES. CUSTOMER HAD RECEIVED WEAK BATTERY ALERTS. CUSTOMER WAS ADVISED TO CLEAN THE BATTERY CAP AND WAS ASSISTED IN TURNING THE ALERTS TO SILENT. THE BLOOD GLUCOSE READING WAS NOT KNOWN AT THE TIME OF THE REPORT. NOTHING FURTHER WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    449981 530G INSULIN PUMP MMT-751NAH OZO OZO MEDTRONIC PUERTO RICO OPERATIONS CO. MMT-751NAH

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR