FDA Adverse Event Malfunction Summary report: N

PARADIGM INSULIN INFUSION PUMP

MDR report key: 5241327 · Received November 20, 2015

Report

Report Number
2032227-2015-68405
Event Type
Malfunction
Date Received
November 20, 2015
Date of Event
November 4, 2015
Report Date
November 4, 2015
Manufacturer
MEDTRONIC MINIMED
Product Code
OYC
PMA / PMN Number
K040676
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
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. 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

IT WAS REPORTED THAT THE CUSTOMER'S DEVICE ALARMED FOR COMPROMISED FORCE SENSOR SYSTEM. NO FURTHER INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
769116 PARADIGM INSULIN INFUSION PUMP INSULIN INFUSION PUMP / SENSOR AUGMENTED OYC MEDTRONIC MINIMED MMT-515LWWL

Patients

Seq Age Sex Outcome Treatment
1