FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 17661984 · Received August 31, 2023

Report

Report Number
3013756811-2023-125219
Event Type
Malfunction
Date Received
August 31, 2023
Date of Event
August 22, 2023
Report Date
October 26, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
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 IS EXPECTED TO BE RETURNED; HOWEVER, THE DEVICE HAS NOT YET BEEN RECEIVED. A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF THE DEVICE IS RECEIVED AND EVALUATION IS PERFORMED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE WAKE BUTTON IS DIFFICULT TO PRESS AND REQUIRES MULTIPLE PRESSES TO TURN ON PUMP SCREEN. CUSTOMER CONTINUED USING THE PUMP FOR INSULIN THERAPY. CUSTOMER'S BLOOD GLUCOSE LEVEL RANGED FROM 161-162 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1189939 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 14 YR Female