FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 3984340 · Received August 6, 2014

Report

Report Number
2032227-2014-05990
Event Type
Malfunction
Date Received
August 6, 2014
Date of Event
July 4, 2014
Report Date
July 4, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

IT IS REPORTED THAT A COSTUMER CALLED COMPLAINING ABOUT A BUTTON ERROR ALARM SETTING OFF ON THEIR INSULIN PUMP. THE PATIENT'S BLOOD GLUCOSE LEVEL WAS AT NOT RECORDED. THE CAUSE OF THE BUTTON ERROR ALARM IS UNKNOWN. THE CUSTOMER WAS INFORMED THAT THE PUMP MUST BE REPLACED AND ALSO WAS ADVISED TO DISCONTINUE USE OF THE INSULIN PUMP AND TO REVERT TO THE BACK UP PLAN. NO FURTHER INFORMATION WAS PROVIDED

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
460734 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-754LWWP

Patients

Seq Age Sex Outcome Treatment
1