FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 4200551 · Received October 24, 2014

Report

Report Number
2032227-2014-42716
Event Type
Malfunction
Date Received
October 24, 2014
Date of Event
September 24, 2014
Report Date
September 24, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INSULIN PUMP HAD AN INTERMITTENT BUTTON RESPONSE ON ESC AND ACT BUTTONS DUE TO CORRODED KEYPAD TRACES. INSULIN PUMP HAD MINOR SCRATCHES ON DISPLAY WINDOW, CRACKED BELT CLIP SLOT, SCRATCHED RESERVOIR TUBE WINDOW AND CRACKED RESERVOIR TUBE LIP.

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.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE BUTTONS ON THE INSULIN PUMP ARE NOT RESPONDING. CUSTOMER NOTICED ISSUE IN THE MORNING WHILE ATTEMPTING TO GIVE A BOLUS. IT WAS STATED THAT THE CUSTOMER KEPT PUSHING BUTTONS UNTIL THEY RESPONDED BUT NOW THEY DON'T RESPOND AT ALL. BLOOD GLUCOSE VALUE WAS 7.9 MMOL/L. NOTHING FURTHER REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
678863 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-754LCAH

Patients

Seq Age Sex Outcome Treatment
1