FDA Adverse Event Injury Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 16285660 · Received February 2, 2023

Report

Report Number
3013756811-2023-12228
Event Type
Injury
Date Received
February 2, 2023
Date of Event
January 11, 2023
Report Date
February 2, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
PMA / PMN Number
K201214
Adverse Event
Yes
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. THE CUSTOMER EXPERIENCED A LOW BLOOD GLUCOSE LEVEL. THE CUSTOMER'S CONTINUOUS GLUCOSE MONITOR READ ¿LOW¿, HOWEVER, A SPECIFIC BLOOD GLUCOSE (BG) VALUE WAS NOT PROVIDED. REPORTEDLY, THE CUSTOMER CONSUMED CARBOHYDRATES TO ADDRESS LOW BG. DURING TROUBLESHOOTING WITH TANDEM TECHNICAL SUPPORT, THE PUMP WAS RESET, AND THE CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
901734 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 25 YR Female Other