BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PUMP, US, 50, INULSIN, 508, BLUE

    MDR report key: 574323 · Received February 18, 2005

    Report

    Report Number
    2032227-2005-00120
    Event Type
    Injury
    Date Received
    February 18, 2005
    Date of Event
    January 29, 2005
    Report Date
    January 29, 2005
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    LZG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    THE CUSTOMER WAS HOSPITALIZED FOR HIGH BGS AND DKA. THE CUSTOMER OFTEN HAS DKA AND PT IS BRITTLE DIABETIC. IN ADDITION, IT WAS STATED THAT CUSTOMER WAS HOSPITALIZED BEFORE AND THE DIABETES MANAGEMENT CONSULTANT WAS NOTIFIED. FURTHERMORE THE CUSTOMER WENT BACK IN THE HOSPITAL WITH DKA AGAIN. THE CUSTOMER WAS NOT FEELING WELL TO TROUBLESHOOT THE DEVICE AT THE TIME OF CALL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PUMP, US, 50, INULSIN, 508, BLUE INFUSION PUMP LZG MEDTRONIC MINIMED MMT-508UB *

    Patients

    Seq Age Sex Outcome Treatment
    1 21 YR Hospitalization