FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 14776964 · Received June 22, 2022

Report

Report Number
3013756811-2022-60258
Event Type
Malfunction
Date Received
June 22, 2022
Date of Event
May 30, 2022
Report Date
May 30, 2022
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
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 RESISTANCE WAS FELT WHEN FILLING MULTIPLE CARTRIDGES DURING THE LOAD SEQUENCE. CUSTOMER CHANGED MULTIPLE CARTRIDGES TO RESOLVE THE ISSUE. CUSTOMER'S BLOOD GLUCOSE RANGED FROM 131-132 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
332135 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1002717

Patients

Seq Age Sex Outcome Treatment
1 43 YR Female