FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 15737616 · Received November 4, 2022

Report

Report Number
3013756811-2022-123568
Event Type
Malfunction
Date Received
November 4, 2022
Date of Event
October 14, 2022
Report Date
November 4, 2022
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00850006613762
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, 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. PER TANDEM'S USER GUIDE: THE SINGLE-USE DISPOSABLE CARTRIDGE CAN HOLD UP TO 300 UNITS (3.0 ML) OF INSULIN. (TFLEX-480 UNITS.).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE INSULIN GAUGE WAS INACCURATE. REPORTEDLY, THE CUSTOMER OVERFILLED THE CARTRIDGE. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 250-253 MG/DL. THE CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2213163 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 66 YR Male