BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MINIMED INFUSION PUMP

    MDR report key: 499964 · Received December 10, 2003

    Report

    Report Number
    2032227-2003-01358
    Event Type
    Injury
    Date Received
    December 10, 2003
    Date of Event
    November 12, 2003
    Report Date
    November 12, 2003
    Manufacturer
    MINIMED INC.
    Product Code
    LZG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    THE CUSTOMER WAS TAKEN TO THE HOSP FOR HIGH BLOOD SUGAR LEVELS. THE SPOUSE WAS UNSURE IF THE CUSTOMER WAS RESPONDING TO THE MANUAL INJECTIONS. IT WAS INDICATED THAT THE CUSTOMER WAS NOT ADMITTED, BUT WILL BE AT THE HOSP FOR A FEW MORE HOURS. THE SPOUSE WANTED THE STATUS OF THE REPLACEMENT PUMP THAT WAS SHIPPED OUT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MINIMED INFUSION PUMP INFUSION PUMP LZG MINIMED INC. MMT-511NAC NA

    Patients

    Seq Age Sex Outcome Treatment
    1 33 YR Hospitalization