FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 9578165 · Received January 10, 2020

Report

Report Number
3013756811-2020-04137
Event Type
Malfunction
Date Received
January 10, 2020
Date of Event
December 18, 2019
Report Date
January 10, 2020
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
UDI-DI
00853052007264
PMA / PMN Number
P180008
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, 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 USB PORT APPEARED TO BE DAMAGED, AND THE PUMP WAS UNABLE TO CHARGE WITHOUT THE USB CABLE BEING MANEUVERED IN THE USB PORT. THE CUSTOMER'S BLOOD GLUCOSE LEVEL RANGED FROM 150-156 MG/DL. REPORTEDLY, THE CUSTOMER CONTINUED TO USE THE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
37174 T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY AUTOMATED INSULIN DOSING, THRESHOLD SUSPEND OZO TANDEM DIABETES CARE 1000096 00853052007264

Patients

Seq Age Sex Outcome Treatment
1 38 YR