FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 4122408 · Received September 18, 2014

Report

Report Number
2032227-2014-24562
Event Type
Malfunction
Date Received
September 18, 2014
Date of Event
August 19, 2014
Report Date
August 19, 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

INSULIN PUMP RECEIVED WITH NO BUTTON RESPONSE DUE TO CORRODED KEYPAD TRACES. INSULIN PUMP RECEIVED WITH CRACKED RESERVOIR TUBE LIP, CRACKED BATTERY TUBE THREADS, CRACKED CASE AT DISPLAY WINDOW CORNERS, MINOR SCRATCHED LCD WINDOW AND SCRATCHED RESERVOIR TUBE WINDOW.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE KEYPAD ON THE INSULIN PUMP WAS UNRESPONSIVE. NO FURTHER INFORMATION REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
579323 PARADIGM REAL-TIME INSULIN INFUSION PUMP OYC MEDTRONIC MINIMED MMT-554WWP

Patients

Seq Age Sex Outcome Treatment
1