FDA Adverse Event Malfunction Summary report: N

SENSOR ENLITE

MDR report key: 4822987 · Received June 6, 2015

Report

Report Number
2032227-2015-18112
Event Type
Malfunction
Date Received
June 6, 2015
Date of Event
May 6, 2015
Report Date
May 19, 2015
Manufacturer
MEDTRONIC MINIMED
Product Code
OZO
PMA / PMN Number
120010
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ
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

CUSTOMER REPORTED VIA PHONE CALL THAT THEY ARE HAVING SENSOR AND NEEDLE ANOMALIES. THE BLOOD GLUCOSE READING IS UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
366783 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A C275U

Patients

Seq Age Sex Outcome Treatment
1 41 YR