BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MEDTRONIC MINIMED

    MDR report key: 5137260 · Received April 12, 2004

    Report

    Report Number
    5137260
    Event Type
    Injury
    Date Received
    April 12, 2004
    Date of Event
    April 4, 2004
    Report Date
    April 12, 2004
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    LKK
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MD, US
    Reporter Occupation
    1

    Narratives

    Description of Event or Problem · 1

    PT COMPLAINED OF ABDOMINAL DISTENTION AND TENDERNESS ALONG WITH DRAINAGE FROM INCISION SITE. ALSO HAD FEVER AND CHILLS. PT WENT TO ER. CT SCAN AND BLOODWORK COME BACK NORMAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC MINIMED IMPLANTABLE PUMP LKK MEDTRONIC MINIMED MMT-2007C 1010381

    Patients

    Seq Age Sex Outcome Treatment
    1 48 YR Hospitalization