FDA Adverse Event Malfunction Summary report: N

TANDEM T:SLIM INSULIN DELIVERY SYS

MDR report key: 3960143 · Received June 24, 2014

Report

Report Number
3007981285-2014-01458
Event Type
Malfunction
Date Received
June 24, 2014
Date of Event
May 24, 2014
Report Date
May 24, 2014
Manufacturer
TANDEM DIABETES CARE INC.
Product Code
LZG
PMA / PMN Number
K11210
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT HAS BEEN RECEIVED FOR EVALUATION; HOWEVER, EVALUATION IS NOT YET COMPLETED. A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem · 1

RECEIVED INFO STATING CUSTOMER HAD MULTIPLE UNEXPECTED PUMP SHUTDOWNS. THERE WAS NO IMPACT TO CUSTOMER'S BLOOD GLUCOSE LEVEL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
367531 TANDEM T:SLIM INSULIN DELIVERY SYS INSULIN PUMP LZG TANDEM DIABETES CARE INC. 004628

Patients

Seq Age Sex Outcome Treatment
1