FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 4111715 · Received September 23, 2014

Report

Report Number
2032227-2014-27525
Event Type
Malfunction
Date Received
September 23, 2014
Date of Event
August 25, 2014
Report Date
August 25, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). 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. CURRENTLY IT IS UNKNOWN WHETHER OR NOT THE DEVICE MAY HAVE CAUSED OR CONTRIBUTED TO THE EVENT. THE DEVICE HAS BEEN RETURNED, BUT NOT YET EVALUATED. FURTHER INFORMATION WILL FOLLOW ONCE THE ANALYSIS HAS BEEN COMPLETED. NO CONCLUSION CAN BE DRAWN AT THIS TIME.

Additional Manufacturer Narrative · 1

THE INSULIN PUMP WAS RECEIVED WITH ALL BUTTONS RESPONDING PROPERLY HOWEVER, CORROSION DAMAGE WAS FOUND AT THE KEYPAD TRACES. NO BUTTON ERROR ALARMS NOTED. THE INSULIN PUMP HAS MINOR SCRATCHES ON LCD DISPLAY WINDOW AND MISSING END CAP STICKER.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE INSULIN PUMP ALARMED BUTTON ERROR. NO FURTHER INFORMATION REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
592584 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-754WWB

Patients

Seq Age Sex Outcome Treatment
1