FDA Adverse Event Malfunction Summary report: N

PARADIGM REAL-TIME INSULIN INFUSION PUMP

MDR report key: 4862348 · Received June 23, 2015

Report

Report Number
2032227-2015-19847
Event Type
Malfunction
Date Received
June 23, 2015
Date of Event
June 2, 2015
Report Date
June 3, 2015
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
P980022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO
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. THE DEVICE WILL BE RETURNED FOR ANALYSIS AND FURTHER INFORMATION WILL FOLLOW ONCE THE ANALYSIS HAS BEEN COMPLETED. NO CONCLUSION CAN BE DRAWN AT THIS TIME. 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

THE CUSTOMER CALLED AND REPORTED A BUTTON ON THE INSULIN PUMP WAS NOT RESPONDING. CUSTOMER'S BLOOD GLUCOSE WAS 104 MG/DL. THE INSULIN PUMP MAY HAVE BEEN EXPOSED TO PERSPIRATION FROM CUSTOMER SWEATING AT THE GYM. IT WAS ADVISED THAT THE CUSTOMER DISCONTINUE USE OF THE DEVICE AND REVERT TO A BACK-UP PLAN. CUSTOMER WAS FURTHER ADVISED THE INSULIN PUMP WOULD BE REPLACED AND AGREED TO RETURN THE PRODUCT FOR ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
405559 PARADIGM REAL-TIME INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-754LCAS

Patients

Seq Age Sex Outcome Treatment
1