BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    T:SLIM X2 INSULIN PUMP

    MDR report key: 10157623 · Received June 16, 2020

    Report

    Report Number
    3013756811-2020-62648
    Event Type
    Malfunction
    Date Received
    June 16, 2020
    Date of Event
    May 28, 2020
    Report Date
    June 16, 2020
    Manufacturer
    TANDEM DIABETES CARE
    Product Code
    OYC
    PMA / PMN Number
    P140015
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    NO PRODUCT WAS RETURNED FOR EVALUATION. SHOULD NEW RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT AN OCCLUSION ALARM OCCURRED. THE ISSUE WAS RESOLVED BY THE TIME OF THE CALL THEREFORE NO TROUBLESHOOTING COULD BE PERFORMED. CUSTOMER'S BLOOD GLUCOSE LEVEL WAS 243-244 MG/DL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    620557 T:SLIM X2 INSULIN PUMP PUMP, INFUSION, INSULIN, TO BE USED WITH INVASIVE GLUCOSE SENSOR OYC TANDEM DIABETES CARE 1002717

    Patients

    Seq Age Sex Outcome Treatment
    1 24 YR INSULIN: NOVOLOG / NOVORAPIDINFUSION SET: AUTOSOF