FDA Adverse Event Injury Summary report: N

SENSOR ENLITE

MDR report key: 4233509 · Received November 6, 2014

Report

Report Number
2032227-2014-48910
Event Type
Injury
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
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY
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 CUSTOMER HAD A BLOOD GLUCOSE LEVEL OF 600 MG/DL THEN LESS THAN AN HOUR LATER HER BLOOD GLUCOSE LEVEL WAS 43 MG/DL. THE CUSTOMER STATED SHE BELIEVED THE INSULIN PUMP'S SETTINGS MAY BE INCORRECT. THE PRODUCT IS NOT BEING RETURNED. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
712921 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A HG05TUW

Patients

Seq Age Sex Outcome Treatment
1 35 YR Other