FDA Adverse Event Injury Summary report: N

SENSOR ENLITE

MDR report key: 4173628 · Received October 15, 2014

Report

Report Number
2032227-2014-38275
Event Type
Injury
Date Received
October 15, 2014
Date of Event
September 1, 2014
Report Date
September 30, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OZO
PMA / PMN Number
120010
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA
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 WAS REPORTED BY THE CUSTOMER, THAT THE AMBULANCE WAS CALLED ON (B)(6) 2014 DUE TO LOW BLOOD GLUCOSE LEVELS AND UNRESPONSIVENESS. CUSTOMER'S BLOOD GLUCOSE LEVELS AT THE TIME 32MG/DL. CUSTOMER WAS TREATED WITH GLUCAGON SHOT, AFTER TREATMENT BLOOD GLUCOSE LEVELS WENT UP TO 87MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
653832 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A

Patients

Seq Age Sex Outcome Treatment
1 60 YR Required Intervention