FDA Adverse Event Malfunction Summary report: N

SENSOR ENLITE

MDR report key: 4241472 · Received November 10, 2014

Report

Report Number
2032227-2014-50524
Event Type
Malfunction
Date Received
November 10, 2014
Date of Event
October 12, 2014
Report Date
October 12, 2014
Manufacturer
MEDTRONIC MINIMED
Product Code
OZO
PMA / PMN Number
120010
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NV
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 BLOOD GLUCOSE LEVEL WAS 157 MG/DL AND THE SENSOR'S REPORTED BLOOD GLUCOSE LEVEL WAS 65 MG/DL. STANDARD TROUBLESHOOTING WAS PERFORMED. IT WAS DISCOVERED THAT THE SENSOR WAS 5 DAYS OLD. THE CUSTOMER HAD ALSO HAD BENT SENSORS IN THE PAST. THE CUSTOMER WAS ADVISED TO REMOVE AND REPLACE THE SENSOR. THE PRODUCT IS NOT BEING RETURNED. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
722313 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A E144U

Patients

Seq Age Sex Outcome Treatment
1 51 YR