FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 3974327 · Received August 1, 2014

Report

Report Number
2032227-2014-05331
Event Type
Malfunction
Date Received
August 1, 2014
Date of Event
July 2, 2014
Report Date
July 2, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

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. THE INSULIN PUMP INVOLVED IN THIS EVENT IS THE PARADIGM REAL-TIME VEO INSULIN INFUSION PUMP, WHICH IS NOT MARKETED IN THE UNITED STATES. HOWEVER, THE DEVICE IS SIMILAR TO THE PARADIGM REAL-TIME INSULIN INFUSION PUMP, WHICH IS MARKETED IN THE UNITED STATES.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE INSULIN PUMP ALARMED NO DELIVERY DURING THE FILL TUBING PROCEDURE. THE BLOOD GLUCOSE READING WAS 199.8 MG/DL. THE CUSTOMER STATED THAT WHEN FILLING THE TUBING, NO DROPS CAME AT THE END OF THE RESERVOIR AND THAT THE DEVICE ONLY WENT UP TO 3.0 UNITS BEFORE SHUTTING DOWN AND ALARMING NO DELIVERY. THE CALLER ALSO NOTED THAT UPON TRYING THE MANUAL PRIME AS NORMAL, THE PROBLEM WAS RECTIFIED. THE CUSTOMER TREATED WITH A MANUAL INJECTION OF 6.0 UNITS AND HAD BEEN OFF THE INSULIN PUMP SINCE. NOTHING FURTHER REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
450220 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-754LWWS

Patients

Seq Age Sex Outcome Treatment
1