FDA Adverse Event
Malfunction
Summary report: N
MMT-712 PARADIGM INSULIN PUMP
MDR report key: 8685915
·
Received June 11, 2019
Report
- Report Number
- 2032227-2019-14246
- Event Type
- Malfunction
- Date Received
- June 11, 2019
- Date of Event
- June 5, 2019
- Report Date
- June 11, 2019
- Manufacturer
- MEDTRONIC PUERTO RICO OPERATIONS CO.
- Product Code
- LZG
- UDI-DI
- 00613994469694
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CH
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). 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 INSULIN PUMP ESC AND ACT KEYS NOT THE FEELING OF PRESSING. CUSTOMER'S BLOOD GLUCOSE LEVEL WAS UNKNOWN. CUSTOMER ALSO STATED THAT THE DID NOT REQUIRE MEDICAL TREATMENT AS BLOOD GLUCOSE WAS NORMAL. THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 483050 | MMT-712 PARADIGM INSULIN PUMP | PUMP, INFUSION, INSULIN | LZG | MEDTRONIC PUERTO RICO OPERATIONS CO. | MMT-712EWS | A9712EWSJ | 00613994469694 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |