FDA Adverse Event Malfunction Summary report: N

TANDEM T:SLIM INSULIN DELIVERY SYS

MDR report key: 3915479 · Received June 5, 2014

Report

Report Number
3007981285-2014-00991
Event Type
Malfunction
Date Received
June 5, 2014
Date of Event
May 8, 2014
Report Date
May 8, 2014
Manufacturer
TANDEM DIABETES
Product Code
LZG
PMA / PMN Number
K111210
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT HAS NOT BEEN RETURNED FOR EVALUATION. SHOULD NEW INFO BECOME AVAILABLE A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT WHEN THE CUSTOMER PRESSES THE SCREEN ON QUICK BOLUS BUTTON, TWICE THE AMOUNT REQUESTED APPEARS ON SCREEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
328860 TANDEM T:SLIM INSULIN DELIVERY SYS INSULIN PUMP LZG TANDEM DIABETES 004628

Patients

Seq Age Sex Outcome Treatment
1