FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH BASAL-IQ TECHNOLOGY

MDR report key: 9997466 · Received April 24, 2020

Report

Report Number
3013756811-2020-41462
Event Type
Malfunction
Date Received
April 24, 2020
Date of Event
April 4, 2020
Report Date
April 24, 2020
Manufacturer
TANDEM DIABETES CARE
Product Code
OZO
UDI-DI
00853052007325
PMA / PMN Number
P180008
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NO PRODUCT WAS RETURNED FOR EVALUATION. SHOULD NEW RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A MINIMUM FILL NOTIFICATION OCCURRED AFTER FILLING THE CARTRIDGE WITH 150 UNITS OF INSULIN. CUSTOMER¿S BLOOD GLUCOSE RANGED FROM 220-374 MG/DL. REPORTEDLY, THE CUSTOMER HAD MANUAL INJECTIONS AVAILABLE AS ALTERNATE INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
459872 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 57 YR