FDA Adverse Event
Malfunction
Summary report: N
T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY
MDR report key: 15878461
·
Received November 29, 2022
Report
- Report Number
- 3013756811-2022-134294
- Event Type
- Malfunction
- Date Received
- November 29, 2022
- Date of Event
- October 14, 2022
- Report Date
- November 29, 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
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 CONTROL IQ SOFTWARE INTERMITTENTLY DID NOT ADJUST INSULIN DELIVERY AS INTENDED. REPORTEDLY, INSULIN WAS BEING DELIVERED BASED OFF THE PUMP PERSONAL PROFILE SETTINGS INSTEAD OF CONTROL IQ SETTINGS DESPITE CONTROL IQ BEING TURNED ON. THERE WAS NO ADVERSE IMPACT TO CUSTOMER'S BLOOD GLUCOSE LEVEL. A PUMP RESET WAS PERFORMED TO ADDRESS THE ISSUE. CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1960371 | 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 | 32 YR | Female |