FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP

MDR report key: 8742339 · Received June 27, 2019

Report

Report Number
3013756811-2019-35885
Event Type
Malfunction
Date Received
June 27, 2019
Date of Event
June 6, 2019
Report Date
June 27, 2019
Manufacturer
TANDEM DIABETES CARE
Product Code
LZG
UDI-DI
00852162004781
PMA / PMN Number
K111210
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, 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 162-165 MG/DL. REPORTEDLY, THE CUSTOMER RELOADED THE CARTRIDGE SUCCESSFULLY AND RECEIVED AN ACCURATE FILL ESTIMATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
532229 T:SLIM X2 INSULIN PUMP INSULIN PUMP LZG TANDEM DIABETES CARE 1000096 00852162004781

Patients

Seq Age Sex Outcome Treatment
1 30 YR