FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 4122446 · Received September 18, 2014

Report

Report Number
2032227-2014-24556
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
IT
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NO BUTTON ERROR ALARM WAS NOTED. HOWEVER, THE PUMP HAD INTERMITTENT BUTTON RESPONSE DUE TO CORRODED KEYPAD TRACES. THE PUMP ALSO HAD A CRACKED RESERVOIR TUBE LIP, CRACKED BATTERY TUBE THREADS, MINOR SCRATCHES ON THE LCD WINDOW, A SCRATCHED RESERVOIR TUBE WINDOW, AND MISSING END CAP STICKER.

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 UNK WHETHER OR NOT THE DEVICE MAY HAVE CAUSED OR CONTRIBUTED TO THE EVENT AS NO PRODUCT HAS BEEN RETURNED. THE DEVICE WILL BE RETURNED FOR ANALYSIS AND FURTHER INFO WILL FOLLOW ONCE THE ANALYSIS HAS BEEN COMPLETED. NO CONCLUSION CAN BE DRAWN AT THIS TIME.

Description of Event or Problem · 1

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
579205 PARADIGM REAL-TIME INSULIN INFUSION PUMP OYC MEDTRONIC MINIMED MMT-754WWB

Patients

Seq Age Sex Outcome Treatment
1