FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 12324331 · Received August 16, 2021

Report

Report Number
3013756811-2021-86946
Event Type
Malfunction
Date Received
August 16, 2021
Date of Event
July 25, 2021
Report Date
August 16, 2021
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
PMA / PMN Number
K201214
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 THE BATTERY GAUGE WAS FLUCTUATING. THE CUSTOMER'S BLOOD GLUCOSE WAS 153-154 MG/DL. THE CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1222709 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 25 YR