FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 16826422 · Received April 27, 2023

Report

Report Number
3013756811-2023-55257
Event Type
Malfunction
Date Received
April 27, 2023
Date of Event
March 27, 2023
Report Date
April 27, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
PMA / PMN Number
K201214
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 MULTIPLE INTERMITTENT ALTITUDE ALARMS OCCURRED. REPORTEDLY, THE PUMP WAS NOT OUTSIDE THE LABELED ALTITUDE OPERATING RANGE. THE CUSTOMER'S BLOOD GLUCOSE LEVEL RANGED FROM 162-181 MG/DL. REPORTEDLY, THE CARTRIDGE WAS RELOADED, AND INSULIN DELIVERY WAS RESUMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1624948 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 38 YR Female INSULIN: NOVOLOG/NOVORAPID