FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP

MDR report key: 9377087 · Received November 26, 2019

Report

Report Number
3013756811-2019-81936
Event Type
Malfunction
Date Received
November 26, 2019
Date of Event
November 7, 2019
Report Date
November 26, 2019
Manufacturer
TANDEM DIABETES CARE
Product Code
OYC
PMA / PMN Number
P140015
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AU
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT AN OCCLUSION ALARM OCCURRED. CUSTOMER'S BLOOD GLUCOSE LEVEL WAS 122-123 MG/DL. A SYSTEM CHECK WAS PERFORMED AND THE PUMP PERFORMED AS INTENDED. REPORTEDLY, THE CUSTOMER REVERTED TO ALTERNATE INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1172193 T:SLIM X2 INSULIN PUMP PUMP, INFUSION, INSULIN, TO BE USED WITH INVASIVE GLUCOSE SENSOR OYC TANDEM DIABETES CARE 1002717

Patients

Seq Age Sex Outcome Treatment
1