FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 8298653 · Received February 1, 2019

Report

Report Number
3013756811-2019-04568
Event Type
Malfunction
Date Received
February 1, 2019
Date of Event
January 11, 2019
Report Date
February 1, 2019
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
UDI-DI
00853052007264
PMA / PMN Number
P180008
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NO PRODUCT WAS RETURNED FOR EVALUATION. SHOULD NEW RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. THE PUMP USER GUIDE STATES DO NOT REUSE CARTRIDGES OR USE CARTRIDGES OTHER THAN THOSE MANUFACTURED BY TANDEM DIABETES CARE, INC. USE OF CARTRIDGES NOT MANUFACTURED BY TANDEM DIABETES CARE, INC. OR REUSE OF CARTRIDGES MAY RESULT IN OVER DELIVERY OR UNDER DELIVERY OF INSULIN. THIS CAN CAUSE VERY LOW OR VERY HIGH BLOOD GLUCOSE. DEVICE NOT RETURNED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE INSULIN GAUGE WAS INACCURATE. CUSTOMER RE-USED A CARTRIDGE TO LOAD ON TO THE PUMP. CUSTOMER¿S BLOOD GLUCOSE WAS 349 MG/DL. REPORTEDLY, THE CUSTOMER LOADED A NEW CARTRIDGE SUCCESSFULLY AND RECEIVED AN ACCURATE FILL ESTIMATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
92280 T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY AUTOMATED INSULIN DOSING, THRESHOLD SUSPEND OZO TANDEM DIABETES CARE 1000096 M147488 00853052007264

Patients

Seq Age Sex Outcome Treatment
1 70 YR INSULIN: NOVOLOG