BEUDAMED
    FDA Adverse Event Other Summary report: N

    MINIMED INFUSION PUMP

    MDR report key: 467032 · Received June 20, 2003

    Report

    Report Number
    2032227-2003-00408
    Event Type
    Other
    Date Received
    June 20, 2003
    Date of Event
    May 27, 2003
    Report Date
    May 27, 2003
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    LZG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    A NURSE CALLED TO REPORT THE CUSTOMER WAS ADMITTED TO THE HOSPITAL FOR HIGH BGS. IT WAS STATED THAT THE CUSTOMER MIGHT HAVE OVER EATEN LAST NIGHT AT A PARTY. TROUBLESHOOTING WAS PERFORMED. THE PUMP PASSED THE TESTING. A FOLLOW UP WITH THE NURSE ALSO INFORMED THAT THE DIAGNOSIS WAS LOW ABDOMINAL PAIN WITH UNKNOWN ORIGIN AND DKA.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MINIMED INFUSION PUMP INFUSION PUMP LZG MEDTRONIC MINIMED MMT-508UT NA

    Patients

    Seq Age Sex Outcome Treatment
    1 * Hospitalization