FDA Adverse Event Malfunction Summary report: N

SENSOR ENLITE

MDR report key: 4132399 · Received October 1, 2014

Report

Report Number
2032227-2014-31233
Event Type
Malfunction
Date Received
October 1, 2014
Date of Event
August 28, 2014
Report Date
September 1, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OZO
PMA / PMN Number
120010
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

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.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CUSTOMER HAS EXPERIENCED SENSOR READING DISCREPANCIES. IT WAS STATED THAT IN ONE ACCUSATION THE INSULIN PUMP WENT INTO THRESHOLD SUSPEND AND WHEN CUSTOMER CHECKED HIS BLOOD GLUCOSE IT WAS AT 100 MG/DL. CUSTOMER STATED THAT HE HAS NOTICED THAT THE ISSUE TENDS TO HAPPEN ON THE 5 AND 6 DAY OF USE OF THE SENSOR AND IT WOULD BE KINKED WHEN REMOVING. NOTHING FURTHER REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
612998 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A

Patients

Seq Age Sex Outcome Treatment
1 28 YR