FDA Adverse Event
Malfunction
Summary report: N
TANDEM T:SLIM INSULIN DELIVERY SYSTEM
MDR report key: 8808720
·
Received July 19, 2019
Report
- Report Number
- 3013756811-2019-20629
- Event Type
- Malfunction
- Date Received
- July 19, 2019
- Date of Event
- April 1, 2019
- Report Date
- July 19, 2019
- Manufacturer
- TANDEM DIABETES CARE
- Product Code
- LZG
- PMA / PMN Number
- K111210
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
POSSIBLE USE ERRORS: USING COLD INSULIN AND OVERFILLING THE CARTRIDGE BAG. PER TANDEM'S T:SLIM USER GUIDE: "INSULIN SHOULD BE AT ROOM TEMPERATURE BEFORE FILLING CARTRIDGE" AND "THE SINGLE-USE DISPOSABLE CARTRIDGE CAN HOLD UP TO 300 UNITS (3.0 ML) OF INSULIN." PUMP SERIAL NUMBERS: (B)(4). CARTRIDGE LOT NUMBERS: M112622, M199320
Description of Event or Problem · 1
QUARTERLY SUMMARY REPORT FOR ALLEGED INSULIN GAUGE ISSUES: IT WAS REPORTED THAT THE INSULIN GAUGE WAS INACCURATE OR A MINIMUM FILL NOTIFICATION WAS RECEIVED AFTER THE CARTRIDGE WAS FILLED WITH A SUFFICIENT AMOUNT OF INSULIN. THE ISSUE WAS RESOLVED BY LOADING A NEW CARTRIDGE OR REVERTING TO AN ALTERNATE METHOD OF INSULIN THERAPY. THERE WAS NO ADVERSE IMPACT TO THE USER.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 599731 | TANDEM T:SLIM INSULIN DELIVERY SYSTEM | INSULIN PUMP | LZG | TANDEM DIABETES CARE | 004628 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | INFUSION SET, INSULIN |