FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH INTEROPERABLE TECHNOLOGY (WITH T:CONNECT MOBILE APP)

MDR report key: 19684465 · Received July 5, 2024

Report

Report Number
3013756811-2024-109566
Event Type
Malfunction
Date Received
July 5, 2024
Date of Event
June 8, 2024
Report Date
July 5, 2024
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
PMA / PMN Number
K203234
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. H3 OTHER TEXT : DEVICE NOT RETURNED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A MINIMUM FILL NOTIFICATION OCCURRED AFTER THE USER FILLED THE CARTRIDGE WITH 140 UNITS OF INSULIN DURING THE LOAD SEQUENCE. THE CUSTOMER ADDED MORE INSULIN TO THE CARTRIDGE TO RESOLVE THE ISSUE. CUSTOMER¿S BLOOD GLUCOSE LEVEL RANGED FROM 251-271 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
902101 T:SLIM X2 INSULIN PUMP WITH INTEROPERABLE TECHNOLOGY (WITH T:CONNECT MOBILE APP) ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1002717

Patients

Seq Age Sex Outcome Treatment
1 64 YR Female INSULIN: NOVOLOG/NOVORAPID