FDA Adverse Event Malfunction Summary report: N

TANDEM T:SLIM INSULIN DELIVERY SYSTEM

MDR report key: 4162120 · Received July 16, 2014

Report

Report Number
3007981285-2014-03003
Event Type
Malfunction
Date Received
July 16, 2014
Date of Event
June 20, 2014
Report Date
June 20, 2014
Manufacturer
TANDEM DIABETES CARE INC.
Product Code
LZG
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED FOR EVALUATION. HOWEVER, THE EVALUATION IS NOT COMPLETE. A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF EVALUATION.

Description of Event or Problem · 1

RECEIVED INFORMATION THAT ALL INSULIN DELIVERY STOPPED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
416438 TANDEM T:SLIM INSULIN DELIVERY SYSTEM INSULIN PUMP LZG TANDEM DIABETES CARE INC. 004628

Patients

Seq Age Sex Outcome Treatment
1 65 YR