FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP

MDR report key: 15146550 · Received August 2, 2022

Report

Report Number
3013756811-2022-82408
Event Type
Malfunction
Date Received
August 2, 2022
Date of Event
June 29, 2022
Report Date
July 13, 2022
Manufacturer
TANDEM DIABETES CARE
Product Code
OYC
UDI-DI
00853052007981
PMA / PMN Number
P140015
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

NO PRODUCT WAS RETURNED FOR EVALUATION. SHOULD NEW RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT INTERMITTENT OCCLUSION ALARMS OCCURRED. CUSTOMER CHANGED THE PUMP SUPPLIES AND SUCCESSFULLY RESUMED INSULIN THERAPY. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 260-301 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1869997 T:SLIM X2 INSULIN PUMP PUMP, INFUSION, INSULIN, TO BE USED WITH INVASIVE GLUCOSE SENSOR OYC TANDEM DIABETES CARE 1000354 00853052007981

Patients

Seq Age Sex Outcome Treatment
1 44 YR Female INFUSION SET: AUTOSOFT XCINSULIN: NOVOLOG / NOVOR