BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SENSOR ENLITE

    MDR report key: 6202918 · Received December 23, 2016

    Report

    Report Number
    2032227-2016-52149
    Event Type
    Malfunction
    Date Received
    December 23, 2016
    Date of Event
    December 19, 2016
    Report Date
    December 19, 2016
    Manufacturer
    MEDTRONIC MINIMED
    Product Code
    OZO
    PMA / PMN Number
    120010
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    DA
    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

    THE CUSTOMER'S MOTHER CALLED TO REPORT A SENSOR BREAK AND A MISSING CANNULA. THE CUSTOMER'S BLOOD GLUCOSE READING WAS UNKNOWN. THE SENSORS WERE REPLACED. NO FURTHER DETAILS WERE PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    852675 SENSOR ENLITE OZO OZO MEDTRONIC MINIMED MMT-7008A F306P

    Patients

    Seq Age Sex Outcome Treatment
    1