FDA Adverse Event Malfunction Summary report: N

T:SLIM G5 SYSTEM

MDR report key: 7794114 · Received August 17, 2018

Report

Report Number
3013756811-2018-28760
Event Type
Malfunction
Date Received
August 17, 2018
Date of Event
July 22, 2018
Report Date
August 17, 2018
Manufacturer
TANDEM DIABETES CARE
Product Code
OYC
UDI-DI
00853052007257515026
PMA / PMN Number
P140015
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PUMP BATTERY WAS INTERMITTENTLY OBSERVED TO BE DEPLETING RAPIDLY. THE CUSTOMER'S BLOOD GLUCOSE (BG) RANGED FROM 150-271 MG/DL. REPORTEDLY, THE CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
634461 T:SLIM G5 SYSTEM CONTINUOUS GLUCOSE MONITOR OYC TANDEM DIABETES CARE 1000096 00853052007257515026

Patients

Seq Age Sex Outcome Treatment
1 66 YR