FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 10792708 · Received November 5, 2020

Report

Report Number
3013756811-2020-122009
Event Type
Malfunction
Date Received
November 5, 2020
Date of Event
October 15, 2020
Report Date
November 5, 2020
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE USER GUIDE STATES: YOUR PUMP CAN STOP INSULIN DELIVERY AND ALERT YOU (OR WHOEVER IS WITH YOU) IF THERE HAS BEEN NO INTERACTION WITH THE PUMP WITHIN A SPECIFIED PERIOD OF TIME. THE DEFAULT FOR THIS ALARM IS PRESET TO 12 HOURS. YOU CAN SET IT ANYWHERE BETWEEN 5 AND 24 HOURS, OR OFF. THIS ALARM NOTIFIES YOU THAT THERE HAS BEEN NO INTERACTION WITH THE PUMP IN THE SPECIFIED NUMBER OF HOURS AND THE PUMP WILL SHUT DOWN AFTER 30 SECONDS. NO PRODUCT WAS RETURNED FOR EVALUATION. SHOULD NEW RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. DEVICE NOT RETURNED.

Description of Event or Problem · 1

IT WAS REPORTED THAT AN AUTO-OFF ALARM OCCURRED. CUSTOMER CONFIRMED THAT THERE HAD BEEN NO INTERACTION WITH THE PUMP FOR AN EXTENDED PERIOD. CUSTOMER ADJUSTED THE AUTO-OFF SAFETY FEATURE TO ADDRESS THE ISSUE. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 251-271 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1259617 T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY AUTOMATED INSULIN DOSING, THRESHOLD SUSPEND OZO TANDEM DIABETES CARE 1002717

Patients

Seq Age Sex Outcome Treatment
1