FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 17780868 · Received September 20, 2023

Report

Report Number
3013756811-2023-134013
Event Type
Malfunction
Date Received
September 20, 2023
Date of Event
August 29, 2023
Report Date
September 20, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00850006613793
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, 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 ALARM 0 OCCURRED. THE PUMP WAS RESET AND A NEW CARTRIDGE WAS LOADED TO RESOLVE THE ISSUE. CUSTOMER'S BLOOD GLUCOSE LEVEL WAS 220-229 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2060403 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1000354 M495424 00850006613793

Patients

Seq Age Sex Outcome Treatment
1 35 YR Female