FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 14931112 · Received July 6, 2022

Report

Report Number
3013756811-2022-68109
Event Type
Malfunction
Date Received
July 6, 2022
Date of Event
June 13, 2022
Report Date
June 17, 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 CARTRIDGE ALARM OCCURRED INTERMITTENTLY DURING INSULIN DELIVERY WITH MULTIPLE CARTRIDGES. REPORTEDLY, THE CARTRIDGE WAS CHANGED TO ADDRESS THE ISSUE. CUSTOMER'S BLOOD GLUCOSE RANGED FROM 251-253 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1620251 T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY AUTOMATED INSULIN DOSING, THRESHOLD SUSPEND OZO TANDEM DIABETES CARE 1002717 W0076420

Patients

Seq Age Sex Outcome Treatment
1 36 YR Male