MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2020-03-31 for T:SLIM X2 INSULIN PUMP WITH INTEROPERABLE TECHNOLOGY 1002717 1005011 manufactured by Tandem Diabetes Care.
[186809171]
The device is expected to be returned; however, the device has not yet been received. A supplemental report will be submitted if the device is received.
Patient Sequence No: 1, Text Type: N, H10
[186809172]
It was reported that the customer experienced continuous elevated blood glucose (bg) levels (value not provided); cause was unknown. Bg was addressed via a manual injection. The customer was instructed to consult with healthcare provider regarding bg level.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3013756811-2020-32026 |
| MDR Report Key | 9903557 |
| Report Source | CONSUMER |
| Date Received | 2020-03-31 |
| Date of Report | 2020-03-31 |
| Date of Event | 2020-03-03 |
| Date Mfgr Received | 2020-03-10 |
| Device Manufacturer Date | 2019-10-01 |
| Date Added to Maude | 2020-03-31 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MICK TRIER |
| Manufacturer City | SAN DIEGO CA 92121 |
| Manufacturer Country | US |
| Manufacturer Postal | 92121 |
| Manufacturer Phone | 8584011451 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | T:SLIM X2 INSULIN PUMP WITH INTEROPERABLE TECHNOLOGY |
| Generic Name | ALTERNATE CONTROLLER ENABLED INFUSION PUMP |
| Product Code | QFG |
| Date Received | 2020-03-31 |
| Model Number | 1002717 |
| Catalog Number | 1005011 |
| Operator | LAY USER/PATIENT |
| Device Availability | Y |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | TANDEM DIABETES CARE |
| Manufacturer Address | 11075 ROSELLE STREET SAN DIEGO CA 92121 US 92121 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2020-03-31 |