FDA Adverse Event Malfunction Summary report: N

T:SLIM G5 SYSTEM

MDR report key: 8647140 · Received May 28, 2019

Report

Report Number
3013756811-2019-29579
Event Type
Malfunction
Date Received
May 28, 2019
Date of Event
May 5, 2019
Report Date
May 28, 2019
Manufacturer
TANDEM DIABETES CARE
Product Code
OYC
UDI-DI
00853052007295
PMA / PMN Number
P140015
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, 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.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE INSULIN GAUGE WAS INACCURATE. CUSTOMER¿S BLOOD GLUCOSE WAS 174 MG/DL. REPORTEDLY, THE CUSTOMER CONTINUED USING THE EXISTING CARTRIDGE FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
438686 T:SLIM G5 SYSTEM CONTINUOUS GLUCOSE MONITOR OYC TANDEM DIABETES CARE 1000096 00853052007295

Patients

Seq Age Sex Outcome Treatment
1 75 YR