FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 18004453 · Received October 25, 2023

Report

Report Number
3013756811-2023-152083
Event Type
Malfunction
Date Received
October 25, 2023
Date of Event
October 2, 2023
Report Date
June 26, 2024
Manufacturer
TANDEM DIABETES CARE
Product Code
QFC
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AU
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 A CARTRIDGE ALARM OCCURRED DURING INSULIN DELIVERY. CUSTOMER REVERTED TO AN ALTERNATE METHOD OF INSULIN THERAPY AND A REPLACEMENT PUMP WAS SENT. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 198-199 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1838732 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFC TANDEM DIABETES CARE 1002717

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown