FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 16242502 · Received January 25, 2023

Report

Report Number
3013756811-2023-09074
Event Type
Malfunction
Date Received
January 25, 2023
Date of Event
January 5, 2023
Report Date
February 23, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
UDI-DI
00853052007301
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THE DEVICE HAS BEEN RECEIVED FOR EVALUATION; HOWEVER, DEVICE EVALUATION IS NOT YET COMPLETE. A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF THE EVALUATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE WAKE BUTTON WAS STICKING. CUSTOMER¿S BLOOD GLUCOSE LEVEL RANGED BETWEEN 123-270 MG/DL. REPORTEDLY THE CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
823627 T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY AUTOMATED INSULIN DOSING, THRESHOLD SUSPEND OZO TANDEM DIABETES CARE 1000096 00853052007301

Patients

Seq Age Sex Outcome Treatment
1 81 YR Male