FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH INTEROPERABLE TECHNOLOGY

MDR report key: 10522464 · Received September 11, 2020

Report

Report Number
3013756811-2020-98046
Event Type
Malfunction
Date Received
September 11, 2020
Date of Event
October 22, 2019
Report Date
September 11, 2020
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00850006613212
PMA / PMN Number
DEN180058
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE TANDEM USER GUIDE INSTRUCTS THE USER TO REMOVE ANY RESIDUAL AIR FROM THE CARTRIDGE. 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 THE INSULIN GAUGE WAS INTERMITTENTLY INACCURATE. REPORTEDLY CUSTOMER DID NOT PERFORM AIR REMOVAL PROCEDURE PRIOR TO LOADING THE CARTRIDGE. CUSTOMER¿S BLOOD GLUCOSE RANGED FROM 160-500 MG/DL. REPORTEDLY, THE CUSTOMER REPLACED THE CARTRIDGE AND CONTINUED INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
988045 T:SLIM X2 INSULIN PUMP WITH INTEROPERABLE TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1002717 00850006613212

Patients

Seq Age Sex Outcome Treatment
1 53 YR