FDA Adverse Event
Injury
Summary report: N
TANDEM T: SLIM INSULIN DELIVERY SYSTEM
MDR report key: 3003928
·
Received March 12, 2013
Report
- Report Number
- 3007981285-2013-00013
- Event Type
- Injury
- Date Received
- March 12, 2013
- Date of Event
- February 13, 2013
- Report Date
- February 13, 2013
- Manufacturer
- TANDEM DIABETES
- Product Code
- LZG
- PMA / PMN Number
- K111210
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OK, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
EVENT NOT LIKELY TO LEAD TO SERIOUS INJURY OR DEATH, T: SLIM USER GUIDE INSTRUCTS USERS TO "ROUTINELY CHECK THEIR BG LEVELS AT LEAST 4 TIMES DAILY (OPTIMALLY 6-8 TIMES DAILY) IN ORDER TO DETECT HYPERGLYCEMIA AND HYPOGLYCEMIA EARLY." ADDITIONALLY, T: SLIM USER GUIDE CAUTIONS USERS "TO PREVENT DKA OR A VERY HIGH BG, YOU MUST BE PREPARED TO INJECT INSULIN IF DELIVERY IS INTERRUPTED FOR ANY REASON." IT IS COMMON PRACTICE FOR INSULIN USERS TO CHECK BLOOD GLUCOSE VALUES FREQUENTLY TO PREVENT LEVELS FROM BECOMING SEVERE ENOUGH TO CAUSE SERIOUS COMPLICATIONS.
Description of Event or Problem · 1
MOTHER REPORTED HER SON WAS EXPERIENCING HIGH BLOOD GLUCOSE LEVELS AND WAS TAKEN TO THE HOSPITAL. ONCE IN THE HOSPITAL, INSULIN WAS ADMINISTERED AND BLOOD GLUCOSE LEVELS WENT DOWN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 103124 | TANDEM T: SLIM INSULIN DELIVERY SYSTEM | INSULIN PUMP | LZG | TANDEM DIABETES | 004628 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 15 YR |