FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 4240672 · Received November 10, 2014

Report

Report Number
2032227-2014-49693
Event Type
Malfunction
Date Received
November 10, 2014
Date of Event
July 17, 2014
Report Date
July 17, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PUMP WAS RECEIVED WITH CRACKED DISPLAY WINDOW CORNER AND CRACKED RESERVOIR TUBE LIP.THE INSULIN PUMP INVOLVED IN THIS EVENT IS THE PARADIGM REAL-TIME VEO INSULIN INFUSION PUMP, WHICH IS NOT MARKETED IN THE UNITED STATES. HOWEVER, THE DEVICE IS SIMILAR TO THE PARADIGM REAL-TIME INSULIN INFUSION PUMP, WHICH IS MARKETED IN THE UNITED STATES.

Description of Event or Problem · 1

IT WAS REPORTED THE CUSTOMER HAD CRACKS ON THEIR INSULIN PUMP. NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
724093 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-754LWWB

Patients

Seq Age Sex Outcome Treatment
1