inforMED
MalfunctionMRZ

CLIP ACC-1601 PUMP NGP 23L

Received Sep 9, 2021 · Event occurred Mar 3, 2021

Report 2032227-2021-191227 · MDR key 12447909

Device

Generic name

Accessories, Pump, Infusion

Manufacturer

Medtronic Minimed

Model number

ACC-1601

Catalog number

ACC-1601

Product problems

  • Break
  • Break

Patient

60 YR

  • Insufficient Information
  • Insufficient Information

Narrative

Additional Manufacturer Narrative

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

INFORMATION RECEIVED BY MEDTRONIC INDICATED THAT THE INSULIN PUMP WAS DAMAGED. THE CUSTOMER REPORTED THAT THE RETAINER RING WAS CRACKED. CUSTOMER STATED THAT RESERVOIR WAS ABLE TO LOCK IN THE PLACE. NO HARM REQUIRING MEDICAL INTERVENTION WAS REPORTED. THE INSULIN PUMP WILL BE RETURNED FOR ANALYSIS.