FDA Adverse Event Malfunction Summary report: N

T:SLIM G5 SYSTEM

MDR report key: 9359713 · Received November 21, 2019

Report

Report Number
3013756811-2019-83958
Event Type
Malfunction
Date Received
November 21, 2019
Date of Event
November 7, 2019
Report Date
November 21, 2019
Manufacturer
TANDEM DIABETES CARE
Product Code
OYC
UDI-DI
00853052007318
PMA / PMN Number
P140015
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED FOR EVALUATION; HOWEVER, DEVICE EVALUATION IS NOT YET COMPLETE. A SUPPLEMENTAL REPORT WILL BE FILED UPON COMPLETION OF THE EVALUATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PUMP BATTERY INTERMITTENTLY DEPLETED QUICKLY. THE CUSTOMER¿S BLOOD GLUCOSE RANGED FROM 153-226 MG/DL. THE CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1153638 T:SLIM G5 SYSTEM CONTINUOUS GLUCOSE MONITOR OYC TANDEM DIABETES CARE 1000096 00853052007318

Patients

Seq Age Sex Outcome Treatment
1 38 YR