BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

    MDR report key: 8663328 · Received June 3, 2019

    Report

    Report Number
    3013756811-2019-31369
    Event Type
    Malfunction
    Date Received
    June 3, 2019
    Date of Event
    May 12, 2019
    Report Date
    June 3, 2019
    Manufacturer
    TANDEM DIABETES CARE
    Product Code
    OZO
    UDI-DI
    00853052007264
    PMA / PMN Number
    P180008
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, 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 PUMP TOUCHSCREEN WAS UNRESPONSIVE AND BECAME FROZEN ON THE BOLUS SCREEN. REPORTEDLY, THE CUSTOMER TRIGGERED THE QUICK BOLUS FEATURE ON THE PUMP PRIOR TO CONTACTING TANDEM TECHNICAL SUPPORT IN ORDER TO CLEAR THE SCREEN, AND RESUME INSULIN THERAPY. CUSTOMER'S BLOOD GLUCOSE WAS 355 MG/DL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    457837 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 48 YR