QUICK-SET? PARADIGM? MMT-394

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor report with the FDA on 2020-03-31 for QUICK-SET? PARADIGM? MMT-394 manufactured by .

Event Text Entries

[185983574] Unomedical reference number (b)(4). Event occurred in the united states. The patient reported that he faced a bent cannula issue and the infusion set being stuck inside of the serter walls, so insulin did not flow. Reportedly, the inside walls caused infusion set to stick to it. It was also stated by the patient that the serter did not show signs of physical/cosmetic damage. Moreover, he cleaned the serter after every 3-4 uses. Further, while he inserted the infusion set (needle- blue plunger) in, it stuck inside the serter, but he and his wife thought it was in there. Subsequently, on (b)(6) 2020 at 3:00 pm, he was admitted in the hospital as his blood glucose level was over 1200 mg/dl and he experienced diabetic ketoacidosis. Moreover, the infusion set was last changed on (b)(6) 2020 at the nighttime. During hospitalization, he received a drip intravenously, as he had a intravenous port on his chest that's how they gave the insulin. On 15-mar-2020 at 5:00 pm, he was released from the hospital. Unomedical do not see bent/kinking as being related to human factors, but rather as a training issue including correct choices of insertion sites and infusion sets and cannula length. Furthermore, the soft cannula is a flexible material that during use and upon removal can bend slightly. No further information available.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3003442380-2020-00229
MDR Report Key9902384
Report SourceDISTRIBUTOR
Date Received2020-03-31
Date Mfgr Received2020-03-17
Date Added to Maude2020-03-31
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Manufacturer StreetAAHOLMVEJ 1-3 OSTED
Manufacturer CityLEJRE, 4320
Manufacturer CountryDA
Manufacturer Postal4320
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameQUICK-SET? PARADIGM?
Generic NameQUICK-SET 46/6 PCC
Product CodeFPA
Date Received2020-03-31
Model NumberMMT-394
Lot Number5927684
Device Availability*
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-31

© 2024 FDA.report
This site is not affiliated with or endorsed by the FDA.