FDA Adverse Event Malfunction Summary report: N

T:SLIM G4 SYSTEM

MDR report key: 9247740 · Received October 28, 2019

Report

Report Number
3013756811-2019-73750
Event Type
Malfunction
Date Received
October 28, 2019
Date of Event
October 5, 2019
Report Date
October 28, 2019
Manufacturer
TANDEM DIABETES CARE
Product Code
OYC
UDI-DI
00852162004408
PMA / PMN Number
P140015
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PUMP COULD NOT BE CHARGED DESPITE THE ATTEMPT OF MULTIPLE USB CABLES, WALL ADAPTERS AND POWER SOURCES. THE CUSTOMER¿S BLOOD GLUCOSE WAS 143-163 MG/DL. REPORTEDLY THE CUSTOMER REVERTED TO MANUAL INJECTIONS FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1038572 T:SLIM G4 SYSTEM INSULIN PUMP OYC TANDEM DIABETES CARE 4628-003 00852162004408

Patients

Seq Age Sex Outcome Treatment
1 42 YR