FDA Adverse Event Malfunction Summary report: N

SENSOR ENLITE

MDR report key: 4211949 · Received October 29, 2014

Report

Report Number
2032227-2014-45370
Event Type
Malfunction
Date Received
October 29, 2014
Date of Event
September 30, 2014
Report Date
September 30, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OZO
PMA / PMN Number
120010
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH
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 THAT THE DIFFERENCE BETWEEN THE CUSTOMER'S ACTUAL BLOOD GLUCOSE READINGS AND THE SENSOR'S READINGS WAS SIGNIFICANT. THE CUSTOMER'S BLOOD GLUCOSE LEVEL WAS 338 MG/DL AND THE CUSTOMER'S SENSOR SHOWED A READING OF 44 MG/DL. STANDARD TROUBLESHOOTING AS PERFORMD. THE SENSOR HAD BEEN IN USE FOR ALMOST 5 DAYS. THE CUSTOMER WAS ADVISED TO CHANGE HER SENSOR. THE PRODUCT IS NOT BEING RETURNED. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
692970 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A HG06S78

Patients

Seq Age Sex Outcome Treatment
1 37 YR