FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH INTEROPERABLE TECHNOLOGY

MDR report key: 20859624 · Received December 5, 2024

Report

Report Number
3013756811-2024-225565
Event Type
Malfunction
Date Received
December 5, 2024
Date of Event
September 14, 2024
Report Date
December 5, 2024
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 A MINIMUM FILL NOTIFICATION OCCURRED AFTER THE USER FILLED THE CARTRIDGE WITH 250 UNITS OF INSULIN DURING THE LOAD SEQUENCE. A NEW CARTRIDGE WAS LOADED TO RESOLVE THE ISSUE. THE CUSTOMER¿S BLOOD GLUCOSE LEVEL WAS 181-253 MG/DL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1376549 T:SLIM X2 INSULIN PUMP WITH INTEROPERABLE TECHNOLOGY ALTERNATE CONTROLLER ENABLED INSULIN INFUSION PUMP QFG TANDEM DIABETES CARE 1002717

Patients

Seq Age Sex Outcome Treatment
1 52 YR Male