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