FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 16772940 · Received April 19, 2023

Report

Report Number
3013756811-2023-53275
Event Type
Malfunction
Date Received
April 19, 2023
Date of Event
March 27, 2023
Report Date
April 19, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00850006613731
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, 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. USE ERROR/AIR REMOVAL THE TANDEM PUMP USER GUIDE INSTRUCTS THE USER TO REMOVE ANY RESIDUAL AIR FROM THE CARTRIDGE. USE ERROR/COLD INSULIN THE CARTRIDGE USER GUIDE CAUTIONS THAT INSULIN SHOULD BE AT ROOM TEMPERATURE BEFORE FILLING A CARTRIDGE. H3 OTHER TEXT : DEVICE NOT RETURNED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE INSULIN GAUGE WAS INACCURATE. REPORTEDLY, THE CUSTOMER WAS NOT REMOVING AIR FROM THE CARTRIDGE DURING THE LOAD SEQUENCE, AND THAT THE CUSTOMER LOADED COLD INSULIN INTO THE CARTRIDGE. TANDEM TECHNICAL SUPPORT EDUCATED THE CUSTOMER THAT THIS IS OFF LABEL. CUSTOMER RELOADED THE CARTRIDGE TO RESOLVE THE ISSUE. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 200-346 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1547588 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1000354 00850006613731

Patients

Seq Age Sex Outcome Treatment
1 59 YR Female