BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    530G INSULIN PUMP

    MDR report key: 4110560 · Received September 23, 2014

    Report

    Report Number
    2032227-2014-27403
    Event Type
    Malfunction
    Date Received
    September 23, 2014
    Date of Event
    August 25, 2014
    Report Date
    August 25, 2014
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    OZO
    PMA / PMN Number
    120010
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA
    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. (B)(4).

    Description of Event or Problem · 1

    CUSTOMER REPORTED TWO MOTOR ERRORS ON HIS INSULIN PUMP. CUSTOMER'S BLOOD GLUCOSE WAS UNKNOWN. HE STATED HIS INSULIN PUMP HAD ALREADY BEEN REPLACED FOR THE SAME ISSUE. NOW THE NEW DEVICE HAS BEEN ALARMING MOTOR ERROR. CUSTOMER STATED HE DID NOT KNOW THAT PRESSING THE ESC BUTTON DURING A BOLUS OR USING (B)(4) BATTERIES WOULD CAUSE A MOTOR ERROR. CUSTOMER COULD NOT TALK AT THE MOMENT BECAUSE HE WAS GOING SOMEWHERE. NOTHING FURTHER REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    592127 530G INSULIN PUMP OZO OZO MEDTRONIC MINIMED MMT-551NAS

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR