FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 10284962 · Received July 16, 2020

Report

Report Number
3013756811-2020-73097
Event Type
Malfunction
Date Received
July 16, 2020
Date of Event
June 22, 2020
Report Date
July 16, 2020
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
UDI-DI
00853052007264
PMA / PMN Number
P180008
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
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 INTERMITTENT CARTRIDGES WERE LEAKING "ON THE SIDE OF THE CARTRIDGE." CUSTOMER LOADED A NEW CARTRIDGE TO ADDRESS THE ISSUE. CUSTOMER'S BLOOD GLUCOSE RANGED FROM 120-237 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
748460 T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY AUTOMATED INSULIN DOSING, THRESHOLD SUSPEND OZO TANDEM DIABETES CARE 1000096 00853052007264

Patients

Seq Age Sex Outcome Treatment
1 45 YR INFUSION SET: AUTOSOFT XC, INSULIN: NOVOLOG