FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 17938876 · Received October 16, 2023

Report

Report Number
3013756811-2023-146813
Event Type
Malfunction
Date Received
October 16, 2023
Date of Event
September 24, 2023
Report Date
December 4, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
UDI-DI
00850006613205
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, 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'S ALARM VOLUME AND VIBRATION WERE TOO LOW. CUSTOMER WILL CONTINUE TO USE CURRENT PUMP. THE CUSTOMER'S BLOOD GLUCOSE LEVEL WAS 130-300 MG/DL. IT WAS REPORTED THAT THE CUSTOMER RECEIVED A CONTINUOUS GLUCOSE MONITOR ERROR 42. THE PUMP WAS RESET, AND THE CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1506029 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1002717 00850006613205

Patients

Seq Age Sex Outcome Treatment
1 63 YR Male