FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 4142174 · Received October 5, 2014

Report

Report Number
2032227-2014-33649
Event Type
Malfunction
Date Received
October 5, 2014
Date of Event
September 5, 2014
Report Date
September 5, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KU
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

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. THE INSULIN PUMP WAS RECEIVED WITH BLANK DISPLAY DUE TO A CORRODED BATTERY CAP CONTACT; HOWEVER, THE DEVICE HAD NORMAL OPERATING CURRENTS. NO UNEXPECTED OFF NO POWER ALARM WAS NOTED. THE INSULIN PUMP HAD CRACKED DISPLAY WINDOW CORNERS, CRACKED RESERVOIR TUBE LIP, AND MINOR SCRATCHED DISPLAY WINDOW.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE INSULIN PUMP HAD A BATTERY PROBLEM AND ALARMED OFF NO POWER. THE REPORTER DID NOT KNOW THE BLOOD GLUCOSE READING. NOTHING FURTHER REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
621992 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-754LWWB

Patients

Seq Age Sex Outcome Treatment
1