MAUDE Adverse Event Report: Medtronic Puerto Rico Operations Co. MiniMed 780G US System BLE Connect 3.0 mg/dL; Alternate Controller Enabled Insulin Infusion Pump

Model Number	MMT-1884
Medical Device Problem Code	Power Problem (3010)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/01/2026
Type of Reportable Event	Malfunction

• Brand Name: MiniMed 780G US System BLE Connect 3.0 mg/dL
• Common Device Name: Alternate Controller Enabled Insulin Infusion Pump
• Manufacturer (Section D): Medtronic Puerto Rico Operations Co.; ceiba norte ind. park #50 road; juncos 00777 -386; PR 00777-3869
• Manufacturer (Section G): Medtronic Puerto Rico Operations Co.; ceiba norte ind. park #50 road; juncos 00777 -386; PR 00777-3869
• Manufacturer Contact: keya patel ; ceiba norte ind. park #50 road; juncos 00777--386 ; PR 00777-3869
• MDR Report Key: 50204214
• Report Number: 2032227-2026-220290
• Device Sequence Number: 13105253
• Product Code: QFG
• Combination Product (Y/N): N
• Initial Reporter State: CO
• Initial Reporter Country: US
• PMA/510(K) Number: P160017
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Consumer
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 08/31/2026

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
• Operator of Device: Lay User/Patient
• Device Model Number: MMT-1884
• Device Catalogue Number: MMT-1884
• Device Lot Number: NG3750830H
• Was Device Available for Evaluation?: Yes
• Date Returned to Manufacturer: 08/17/2026
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 08/02/2026
• Supplement Date Received by Manufacturer: 08/18/2026
• Initial Report FDA Received Date: 08/31/2026
• Supplement Report FDA Received Date: 08/31/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 04/05/2024
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Patient Age: 62 YR
• Patient Sex: Male
• Patient Weight: 165 LB