FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 18029853 · Received October 30, 2023

Report

Report Number
3013756811-2023-159696
Event Type
Malfunction
Date Received
October 30, 2023
Date of Event
October 6, 2023
Report Date
October 30, 2023
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
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.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PUMP WAS NOT EXPOSED TO EXTREME TEMPERATURES, BUT A TEMPERATURE ALARM OCCURRED. CUSTOMER CLEARED THE ALARM TO ADDRESS THE ISSUE. CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 243-244 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1850763 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 65 YR Male