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 |