FDA Adverse Event
Injury
Summary report: N
SENSOR ENLITE
MDR report key: 4233677
·
Received November 6, 2014
Report
- Report Number
- 2032227-2014-49192
- Event Type
- Injury
- Date Received
- November 6, 2014
- Date of Event
- October 9, 2014
- Report Date
- October 10, 2014
- Manufacturer
- MEDTRONIC MINIMED
- Product Code
- OZO
- PMA / PMN Number
- 120010
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- WA
- 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'S BLOOD GLUCOSE LEVEL WAS OVER 500 MG/DL DUE TO A BENT CANNULA ON HIS UNOMEDICAL INFUSION SET. THE CUSTOMER ALSO MENTIONED PAIN WHEN INSERTING THE SENSOR AND FREQUENT LOST SENSOR ALERTS. TROUBLESHOOTING WAS NOT PERFORMED. THE PRODUCT IS NOT BEING RETURNED. NOTHING FURTHER WAS REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 714437 | SENSOR ENLITE | OZO | OZO | MEDTRONIC MINIMED | MMT-7008A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 36 MO | Other |