FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 14136740 · Received April 18, 2022

Report

Report Number
3013756811-2022-35096
Event Type
Malfunction
Date Received
April 18, 2022
Date of Event
March 26, 2022
Report Date
March 26, 2022
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 · 0

DEVICE NOT RETURNED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A MALFUNCTION ALARM OCCURRED. DURING TROUBLESHOOTING WITH TANDEM TECHNICAL SUPPORT, THE MALFUNCTION ALARM WAS CLEARED, AND INSULIN DELIVERY WAS RESUMED SUCCESSFULLY. CUSTOMER'S BLOOD GLUCOSE RANGED FROM 251-253 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
605936 T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY AUTOMATED INSULIN DOSING, THRESHOLD SUSPEND OZO TANDEM DIABETES CARE 1000354

Patients

Seq Age Sex Outcome Treatment
1 18 YR Male