FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 15380409 · Received September 8, 2022

Report

Report Number
3013756811-2022-98071
Event Type
Malfunction
Date Received
September 8, 2022
Date of Event
May 20, 2022
Report Date
August 16, 2022
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00850006613793
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, 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 THE BATTERY GAUGE WAS FLUCTUATING AND THAT THE PUMP SHUT OFF UNEXPECTEDLY. THE CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY. IT WAS ALSO REPORTED THAT A MINIMUM FILL NOTIFICATION OCCURRED AFTER THE USER FILLED THE CARTRIDGE WITH 300 UNITS OF INSULIN DURING THE LOAD SEQUENCE. THE CUSTOMER RE-LOADED THE CARTRIDGE TO RESOLVE THE ISSUE. THE CUSTOMER'S BLOOD GLUCOSE WAS 120 - 330 MG/DL. IT WAS ALSO REPORTED THAT THE INSULIN GAUGE WAS INTERMITTENTLY INACCURATE. CUSTOMER DECLINED TO TROUBLESHOOT THE ISSUE WITH TANDEM TECHNICAL SUPPORT, THEREFORE NO ADDITIONAL INFORMATION WAS OBTAINED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2107891 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1000354 00850006613793

Patients

Seq Age Sex Outcome Treatment
1 24 YR Female