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 |