FDA Adverse Event Injury Summary report: N

SENSOR ENLITE MMT-7008A

MDR report key: 4150366 · Received October 7, 2014

Report

Report Number
2032227-2014-35075
Event Type
Injury
Date Received
October 7, 2014
Date of Event
August 16, 2014
Report Date
September 8, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OZO
PMA / PMN Number
120010
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX
Reporter Occupation
PATIENT

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 IS REPORTED THAT THE PATIENT EXPERIENCED A HIGH BLOOD GLUCOSE LEVEL. LEVEL AT THE TIME WAS 535MG/DL. TROUBLE SHOOTING WAS CONDUCTED AND WE EXPLAINED THE POSSIBLE REASONS FOR A HIGH BLOOD GLUCOSE LEVEL TO THE PATIENT. THE DEVICE IS NOT BEING RETURNED. NO FURTHER INFORMATION AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
629330 SENSOR ENLITE MMT-7008A OZO OZO MEDTRONIC MINIMED MMT-7008A

Patients

Seq Age Sex Outcome Treatment
1 9 YR