FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 17304608 · Received July 12, 2023

Report

Report Number
3013756811-2023-96516
Event Type
Malfunction
Date Received
July 12, 2023
Date of Event
June 21, 2023
Report Date
July 12, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
UDI-DI
00850006613731
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, 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. H3 OTHER TEXT : DEVICE NOT RETURNED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A CARTRIDGE CHANGE ERROR OCCURRED. THE CUSTOMER LOADED A NEW CARTRIDGE TO RESOLVE THE ISSUE. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 150-258 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
803548 T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY AUTOMATED INSULIN DOSING, THRESHOLD SUSPEND OZO TANDEM DIABETES CARE 1000354 00850006613731

Patients

Seq Age Sex Outcome Treatment
1 42 YR Female