FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 4200534 · Received October 24, 2014

Report

Report Number
2032227-2014-42722
Event Type
Malfunction
Date Received
October 24, 2014
Date of Event
September 24, 2014
Report Date
August 22, 2019
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
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. THE DEVICE WILL BE RETURNED FOR ANALYSIS AND FURTHER INFORMATION WILL FOLLOW ONCE THE ANALYSIS HAS BEEN COMPLETED. NO CONCLUSION CAN BE DRAWN AT THIS TIME. 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.

Additional Manufacturer Narrative · 1

DEVICE RECEIVED WITH NO BUTTON RESPONSE AT ESC, ACT, UP AND DOWN DUE TO UNLOCKED J2 OR LCD KEYPAD CONNECTOR DURING VISUAL INSPECTION. UNABLE TO PERFORM OPERATING CURRENTS, SELF TEST AND DISPLACEMENT TEST DUE TO NO BUTTON RESPONSE. NO BUTTON ERROR ALARM DURING TESTING.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE INSULIN PUMP ALARMED BUTTON ERROR. NOTHING FURTHER REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
679080 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-554LWWP

Patients

Seq Age Sex Outcome Treatment
1