FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 8861850 · Received August 5, 2019

Report

Report Number
3013756811-2019-48049
Event Type
Malfunction
Date Received
August 5, 2019
Date of Event
July 16, 2019
Report Date
August 5, 2019
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
UDI-DI
00853052007325
PMA / PMN Number
P180008
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT A MALFUNCTION ALARM OCCURRED. CUSTOMER'S BLOOD GLUCOSE LEVEL WAS 210 MG/DL. REPORTEDLY, THE CUSTOMER HAD MANUAL INJECTIONS AS ALTERNATE INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
655195 T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY AUTOMATED INSULIN DOSING, THRESHOLD SUSPEND OZO TANDEM DIABETES CARE 1000096 00853052007325

Patients

Seq Age Sex Outcome Treatment
1 15 YR