FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 15366127 · Received September 6, 2022

Report

Report Number
3013756811-2022-95666
Event Type
Malfunction
Date Received
September 6, 2022
Date of Event
August 14, 2022
Report Date
August 14, 2022
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00850006613762
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 0

IT WAS REPORTED THAT INTERMITTENT MALFUNCTION ALARMS OCCURRED. REPORTEDLY, THE CUSTOMER CONTINUED TO USE CURRENT PUMP FOR INSULIN THERAPY. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 180 - 182 MG/DL..

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1717639 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1002717 00850006613762

Patients

Seq Age Sex Outcome Treatment
1 46 YR Male