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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: UNOMEDICAL DEVICES S.A DE C.V I-PORT ADVANCE; CATHETER,INTRAVASCULAR,THERAPEUTIC,SHORT-TERM LESS THAN 30 DAYS

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UNOMEDICAL DEVICES S.A DE C.V I-PORT ADVANCE; CATHETER,INTRAVASCULAR,THERAPEUTIC,SHORT-TERM LESS THAN 30 DAYS Back to Search Results
Model Number MMT-100T
Medical Device Problem Codes Complete Blockage (1094); Material Twisted/Bent (2981)
Health Effect - Clinical Code Hyperglycemia (1905)
Date of Event 05/11/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
E1: name: medtronic minimed.Country: united states of america.Street: 18000 devonshire street.City: northridge.State: california.Zip code: 91325 ¿ 1219.Based on the available information, this event is deemed to be a serious injury.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: 3003442380.
 
Event or Problem Description
It was reported that the patient experienced high blood glucose due to bent cannula on (b)(6) 2026.And insulin was administered to treat high blood glucose.
 
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Brand Name
I-PORT ADVANCE
Common Device Name
CATHETER,INTRAVASCULAR,THERAPEUTIC,SHORT-TERM LESS THAN 30 DAYS
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
pamela meadows
aaholmvej 1 - 3
osted
lejre 4320
DA   4320
6032470255
MDR Report Key25645143
Report Number3003442380-2026-40527
Device Sequence Number12228612
Product Code FOZ
UDI-Device Identifier05705244009356
UDI-Public05705244009356
Combination Product (Y/N)N
Initial Reporter CountryBR
PMA/510(K) Number
K120337
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) 05/28/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Operator of Device Lay User/Patient
Device Model NumberMMT-100T
Device Lot Number6004820
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 05/28/2026
Initial Report FDA Received Date06/27/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured12/12/2023
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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