FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 11607681 · Received April 2, 2021

Report

Report Number
3013756811-2021-37737
Event Type
Malfunction
Date Received
April 2, 2021
Date of Event
March 15, 2021
Report Date
April 2, 2021
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AU
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 ALTITUDE ALARM OCCURRED. REPORTEDLY, THE PUMP WAS NOT OUTSIDE THE LABELED ALTITUDE OPERATING RANGE. THE CUSTOMER'S BLOOD GLUCOSE WAS 210-211 MG/DL. REPORTEDLY, THE SAME CARTRIDGE WAS LOADED AND INSULIN DELIVERY WAS RESUMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
506401 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