FDA Adverse Event Malfunction Summary report: N

SENSOR ENLITE

MDR report key: 4233492 · Received November 6, 2014

Report

Report Number
2032227-2014-48848
Event Type
Malfunction
Date Received
November 6, 2014
Date of Event
October 9, 2014
Report Date
October 9, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OZO
PMA / PMN Number
120010
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
ID
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. 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 CUSTOMER'S INSULIN PUMP ALARMED THRESHOLD SUSPEND DUE TO A DIFFERENCE BETWEEN THE BLOOD GLUCOSE READINGS VERSUS THE SENSOR GLUCOSE READINGS. CUSTOMER STATED THAT THE SENSOR WAS READING 64 MG/DL WHILE THE BLOOD GLUCOSE READINGS WERE 123 MG/DL. CUSTOMER PREVIOUSLY NOTICED BENT CANNULAS. NO FURTHER INFORMATION REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
712846 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A HG072RD

Patients

Seq Age Sex Outcome Treatment
1 14 YR