FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 16916206 · Received May 11, 2023

Report

Report Number
3013756811-2023-62633
Event Type
Malfunction
Date Received
May 11, 2023
Date of Event
April 23, 2023
Report Date
July 6, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00850006613786
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
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 PUMP TOUCH SCREEN WAS UNREADABLE. REPORTEDLY, THE SCREEN HAD INK BLOTS THAT BLOCKED GRAPHICS AND TEXT. CUSTOMER¿S BLOOD GLUCOSE LEVEL RANGED BETWEEN 180-211 MG/DL. REPORTEDLY THE CUSTOMER HAD AN ALTERNATE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
817855 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 18 YR Male