FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 4243721 · Received November 11, 2014

Report

Report Number
2032227-2014-50447
Event Type
Malfunction
Date Received
November 11, 2014
Date of Event
October 14, 2014
Report Date
October 14, 2014
Manufacturer
MEDTRONIC PUERTO RICO OPERATIONS CO.
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
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. 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. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CUSTOMER RECEIVED AN UNEXPECTED RESTART ALARM AFTER INSERTING A NEW BATTERY AND THE CUSTOMER COULD NOT CLEAR THE ALARM DUE TO UNRESPONSIVE BUTTONS ON THE KEYPAD. THE CUSTOMER'S BLOOD GLUCOSE WAS 10 MMOL/L. LEADING UP TO THE KEYPAD ISSUES, THE CUSTOMER WAS REPORTEDLY IN A HUMID CLIMATE. THE CUSTOMER WAS ADVISED TO DISCONTINUE USE AND REVERT TO A BACK-UP PLAN. NOTHING FURTHER WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
726782 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC PUERTO RICO OPERATIONS CO. MMT-722WWS

Patients

Seq Age Sex Outcome Treatment
1