FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 17979768 · Received October 20, 2023

Report

Report Number
3013756811-2023-149267
Event Type
Malfunction
Date Received
October 20, 2023
Date of Event
September 29, 2023
Report Date
October 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
FL, 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. THE TANDEM PUMP USER GUIDE INSTRUCTS THE USER TO REMOVE ANY RESIDUAL AIR FROM THE CARTRIDGE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE INSULIN GAUGE WAS INACCURATE AND STATIC INTERMITTENTLY. CUSTOMER REPORTED NOT REMOVING AIR FROM THE CARTRIDGE. CUSTOMER WAS EDUCATED ON THE CORRECT FILL PROCESS PER THE USER GUIDE. CUSTOMER LOADED A NEW CARTRIDGE TO RESOLVE THE ISSUE. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 111-127 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1149155 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1000354 00850006613793

Patients

Seq Age Sex Outcome Treatment
1 73 YR Female