FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 16067431 · Received December 29, 2022

Report

Report Number
3013756811-2022-148646
Event Type
Malfunction
Date Received
December 29, 2022
Date of Event
December 9, 2022
Report Date
December 29, 2022
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00850006613762
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, 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 INSULIN GAUGE WAS INACCURATE. ADDITIONALLY. IT WAS REPORTED THA A MINIMUM FILL NOTIFICATION OCCURRED AFTER THE USER FILLED THE CARTRIDGE WITH 130 UNITS OF INSULIN DURING THE LOAD SEQUENCE CUSTOMER LOADED A NEW CARTRIDGE TO RESOLVE THE ISSUE. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 220-330 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
471940 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 92 YR Female INSULIN TYPE: NOVOLOG/ NOVORAPID