FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 15252895 · Received August 18, 2022

Report

Report Number
3013756811-2022-86210
Event Type
Malfunction
Date Received
August 18, 2022
Date of Event
July 27, 2022
Report Date
July 27, 2022
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00853052007264
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NM, 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. THE TANDEM USER GUIDE INSTRUCTS THE USER TO REMOVE ANY RESIDUAL AIR FROM THE CARTRIDGE.

Description of Event or Problem · 0

IT WAS REPORTED THAT A MINIMUM FILL NOTIFICATION OCCURRED AFTER THE USER FILLED THE CARTRIDGE WITH 300 UNITS OF INSULIN DURING THE LOAD SEQUENCE. REPORTEDLY, THE CUSTOMER WAS NOT PERFORMING THE AIR REMOVAL STEP. A NEW CARTRIDGE WAS LOADED TO RESOLVE THE ISSUE. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 111-180 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2530525 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1000096 60246816 00853052007264

Patients

Seq Age Sex Outcome Treatment
1 67 YR Female