BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

    MDR report key: 16486889 · Received March 6, 2023

    Report

    Report Number
    3013756811-2023-29833
    Event Type
    Malfunction
    Date Received
    March 6, 2023
    Date of Event
    February 10, 2023
    Report Date
    March 28, 2023
    Manufacturer
    TANDEM DIABETES CARE
    Product Code
    QFG
    UDI-DI
    00850006613786
    PMA / PMN Number
    K201214
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, 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 A CARTRIDGE ALARM OCCURRED DURING THE LOAD SEQUENCE AND DURING INSULIN DELIVERY WITH MULTIPLE CARTRIDGES. CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY AND HAD AN ALTERNATE METHOD OF INSULIN DELIVERY AVAILABLE. CUSTOMER¿S BLOOD GLUCOSE WAS 120-220 MG/DL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    612047 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1002717 00850006613786

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR Male