inforMED
MalfunctionMRZ

CLIP ACC-1601 PUMP NGP 23L

Received Sep 28, 2021 · Event occurred Sep 25, 2021

Report 2032227-2021-198713 · MDR key 12538805

Device

Generic name

Accessories, Pump, Infusion

Manufacturer

Medtronic Minimed

Model number

ACC-1601

Catalog number

ACC-1601

Product problems

  • Patient Device Interaction Problem
  • Patient Device Interaction Problem

Patient

26 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 HAD A DAMAGED RETAINER RING. THE CUSTOMER STATED THAT THE RESERVOIR DOES LOCK INTO PLACE. CUSTOMER INFORMED RETAINER BROKE DUE TO UNCLIPPING IT THEN IT BROKE. NO HARM REQUIRING MEDICAL INTERVENTION WAS REPORTED. THE INSULIN PUMP WILL NOT BE RETURNED FOR ANALYSIS.