MAUDE Adverse Event Report: UNOMEDICAL S.A. de C.V. Av Quick Set; Set, Administration, Intravascular

Model Number	MMT-399A
Medical Device Problem Codes	Complete Blockage (1094); Material Twisted/Bent (2981)
Health Effect - Clinical Code	Hyperglycemia (1905)
Date of Event	08/30/2026
Type of Reportable Event	Serious Injury
Event or Problem Description
It was reported that the patient experienced an insulin flow blocked alarm, a bent infusion set cannula, and high blood glucose of 178 mg/dl.The high blood glucose persisted for 1 to 2 hours and was treated with a pump injection on (b)(6) 2026.
Additional Manufacturer Narrative
Based on the available information, this event is deemed to be a reportable 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.

• Brand Name: Quick Set
• Common Device Name: Set, Administration, Intravascular
• Manufacturer (Section D): UNOMEDICAL S.A. de C.V. Av; industrial falcon lote 7; parque ind. del norte; reynosa 88736 ; MX 88736
• Manufacturer (Section G): UNOMEDICAL S.A. de C.V. Av; industrial falcon lote 7; parque ind. del norte; reynosa 88736 ; MX 88736
• Manufacturer Contact: armando cuello ; aaholmvej 1 - 3; osted; lejre 4320 ; DA 4320 ; +1(603)247-0255
• MDR Report Key: 50946370
• Report Number: 3003442380-2026-010908
• Device Sequence Number: 9552074
• Product Code: FPA
• UDI-Device Identifier: 05705244017511
• UDI-Public: 05705244017511
• Combination Product (Y/N): N
• Initial Reporter State: CA
• Initial Reporter Country: US
• PMA/510(K) Number: K160648
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Consumer
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• 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?: Yes
• Is this a Product Problem Report?: No
• Operator of Device: Lay User/Patient
• Device Model Number: MMT-399A
• Device Lot Number: 6015613
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 08/31/2026
• Initial Report FDA Received Date: 09/30/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 09/29/2025
• 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 Number: 1
• Patient Sex: Unknown