FDA Adverse Event Malfunction Summary report: N

TANDEM T:SLIM INSULIN DELIVERY SYSTEM

MDR report key: 7961276 · Received October 12, 2018

Report

Report Number
3013756811-2018-31993
Event Type
Malfunction
Date Received
October 12, 2018
Date of Event
August 26, 2018
Report Date
October 12, 2018
Manufacturer
TANDEM DIABETES CARE
Product Code
LZG
PMA / PMN Number
K111210
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SERIAL NUMBERS: (B)(4). LOT NUMBERS: M021510, M022046, POSSIBLE USE ERRORS: OVERFILLING THE CARTRIDGE OR REUSING THE CARTRIDGE. THE T:SLIM USER GUIDE STATES: "THE SINGLE-USE DISPOSABLE CARTRIDGE CAN HOLD UP TO 300 UNITS (3.0 ML) OF INSULIN."

Description of Event or Problem · 1

QUARTERLY SUMMARY REPORT FOR ALLEGED CARTRIDGE LEAKING: IT WAS REPORTED THAT THE CARTRIDGE WAS LEAKING INSULIN OR INSULIN WAS OBSERVED ON OR AROUND THE PUMP. ISSUE WAS RESOLVED BY LOADING A NEW CARTRIDGE OR CONTINUING TO USE THE SAME CARTRIDGE. THERE WAS NO ADVERSE EFFECT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
800868 TANDEM T:SLIM INSULIN DELIVERY SYSTEM INSULIN PUMP LZG TANDEM DIABETES CARE 004628

Patients

Seq Age Sex Outcome Treatment
1