BEUDAMED
    FDA Adverse Event Injury Summary report: N

    T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

    MDR report key: 16984952 · Received May 23, 2023

    Report

    Report Number
    3013756811-2023-68994
    Event Type
    Injury
    Date Received
    May 23, 2023
    Date of Event
    May 4, 2023
    Report Date
    May 23, 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 THE CONTROL IQ SOFTWARE DID NOT ADJUST INSULIN AS EXPECTED. 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'S BLOOD GLUCOSE LEVEL RANGED FROM 493-494 MG/DL. THE CUSTOMER REQUIRED ASSISTANCE TO TREAT BG LEVEL. THE CONTACT ASSISTED CUSTOMER IN CHANGING THE CARTRIDGE, INFUSION SET, AND DELIVERING A BOLUS. CUSTOMER DECLINED FURTHER TROUBLESHOOTING FROM TANDEM TECHNICAL SUPPORT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    244448 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 13 YR Female