FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 8388403 · Received March 4, 2019

Report

Report Number
3013756811-2019-10669
Event Type
Malfunction
Date Received
March 4, 2019
Date of Event
February 11, 2019
Report Date
March 4, 2019
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
UDI-DI
00853052007264
PMA / PMN Number
P180008
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, 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. DEVICE NOT RETURNED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PUMP BATTERY WAS OBSERVED TO BE DEPLETING RAPIDLY WHICH LED TO A PUMP SHUTDOWN. THE CUSTOMER¿S BLOOD GLUCOSE WAS BETWEEN 180-380 MG/DL. REPORTEDLY THE CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
180218 T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY AUTOMATED INSULIN DOSING, THRESHOLD SUSPEND OZO TANDEM DIABETES CARE 1000096 00853052007264

Patients

Seq Age Sex Outcome Treatment
1 15 YR