FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 15233657 · Received August 16, 2022

Report

Report Number
3013756811-2022-86595
Event Type
Malfunction
Date Received
August 16, 2022
Date of Event
July 28, 2022
Report Date
October 17, 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
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

DEVICE NOT RETURNED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PUMP TOUCH SCREEN WAS UNREADABLE. REPORTEDLY, THE SCREEN WAS DISTORTED WHICH BLOCKED GRAPHICS AND TEXT. CUSTOMER'S BLOOD GLUCOSE RANGED FROM 210-211 MG/DL. THE CUSTOMER REVERTED TO MANUAL INJECTIONS FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1916817 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 3 YR Male