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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: UNOMEDICAL DEVICES S.A DE C.V INSET II; SET, ADMINISTRATION, INTRAVASCULAR

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UNOMEDICAL DEVICES S.A DE C.V INSET II; SET, ADMINISTRATION, INTRAVASCULAR Back to Search Results
Model Number MMT-941A600
Medical Device Problem Code Premature Separation (4045)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/20/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Name: medtronic minimed, entity id: (b)(6), street: 18000 devonshire street, city: northridge state: ca zip code: 91325 zip four: 1219 e1: patient city: (b)(6).Patient country: canada.Based on the available information, this event is deemed to be a reportable malfunction.To date no additional information has been received.Should additional information become available, a follow-up report will be submitted.Fda registration number: reporting site: 8021545, manufacturing site:.
 
Event or Problem Description
It was reported that patient experienced infusion set detachment on (b)(6) 2026, attributed to sleeping and showering affecting adhesive integrity.
 
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Brand Name
INSET II
Common Device Name
SET, ADMINISTRATION, INTRAVASCULAR
Manufacturer (Section D)
UNOMEDICAL DEVICES S.A DE C.V
ave.fomento industrial l9 m3
parque industrial del norte
reynosa,tamps. 88736
MX  88736
Manufacturer (Section G)
UNOMEDICAL DEVICES S.A DE C.V
ave.fomento industrial l9 m3
parque industrial del norte
reynosa,tamps. 88736
MX   88736
Manufacturer Contact
courtney smith
aaholmvej 1 - 3
osted
lejre 4320
DA   4320
6032470255
MDR Report Key24912348
Report Number3003442380-2026-81948
Device Sequence Number21289090
Product Code FPA
UDI-Device Identifier05705244020306
UDI-Public05705244020306
Combination Product (Y/N)N
PMA/510(K) Number
K160648
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Consumer
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 03/21/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Model NumberMMT-941A600
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/21/2026
Initial Report FDA Received Date04/17/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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