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