FDA Adverse Event Malfunction Summary report: N

T:SLIM G5 SYSTEM

MDR report key: 7884918 · Received September 18, 2018

Report

Report Number
3013756811-2018-33092
Event Type
Malfunction
Date Received
September 18, 2018
Date of Event
September 2, 2018
Report Date
September 18, 2018
Manufacturer
TANDEM DIABETES CARE
Product Code
OYC
UDI-DI
00853052007257517651
PMA / PMN Number
P140015
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS EXPECTED TO BE RETURNED; HOWEVER, THE DEVICE HAS NOT YET BEEN RECEIVED. A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF THE DEVICE IS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT AN ALTITUDE ALARM OCCURRED WHILE THE CUSTOMER WAS NOT OUTSIDE OF THE LABELED OPERATING ALTITUDE RANGE. CUSTOMER'S BLOOD GLUCOSE RANGED FROM 240-350 MG/DL. REPORTEDLY, THE CUSTOMER LOADED A NEW CARTRIDGE AND WAS ULTIMATELY ABLE TO CLEAR THE ALARM AND RESUME INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
726936 T:SLIM G5 SYSTEM CONTINUOUS GLUCOSE MONITOR OYC TANDEM DIABETES CARE 1000096 00853052007257517651

Patients

Seq Age Sex Outcome Treatment
1 50 YR