FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 16130647 · Received January 10, 2023

Report

Report Number
3013756811-2023-00078
Event Type
Malfunction
Date Received
January 10, 2023
Date of Event
December 18, 2022
Report Date
January 10, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00853052007264
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 0

IT WAS REPORTED THAT AN ALTITUDE ALARM OCCURRED. REPORTEDLY, THE PUMP WAS NOT OUTSIDE THE LABELED ALTITUDE OPERATING RANGE. SUBSEQUENTLY, A CARTRIDGE CHANGE ERROR OCCURRED WITH MULTIPLE CARTRIDGES. THE CUSTOMER REVERTED TO AN ALTERNATE METHOD OF INSULIN THERAPY. CUSTOMER'S BLOOD GLUCOSE LEVEL WAS 213-220 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1724524 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1002717 00853052007264

Patients

Seq Age Sex Outcome Treatment
1 22 YR Male