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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Tandem Diabetes Care Tandem Mobi Insulin Pump with Control-IQ+ Technology; Alternate Controller Enabled Insulin Infusion Pump

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Tandem Diabetes Care Tandem Mobi Insulin Pump with Control-IQ+ Technology; Alternate Controller Enabled Insulin Infusion Pump Back to Search Results
Model Number 1004000
Medical Device Problem Code Pumping Stopped (1503)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/23/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that pump displayed malfunction alarm code 19 and was not able to be reset.There was no adverse impact to the customer¿s blood glucose level.Customer switched to insulin injections as backup therapy while technical support arranged for replacement pump, confirmed shipping details, provided instructions for storage mode and return of problematic pump within 10 days, and advised customer to enter pump settings and reconnect continuous glucose monitor to replacement pump.
 
Additional Manufacturer Narrative
In use at the time of the event: cgm model: unknown.Mobile os: ios / ios_iphone 13 pro / ios_17.0.2.
 
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Brand Name
Tandem Mobi Insulin Pump with Control-IQ+ Technology
Common Device Name
Alternate Controller Enabled Insulin Infusion Pump
Manufacturer (Section D)
Tandem Diabetes Care
12400 high bluff drive
san diego CA 92130
Manufacturer Contact
john connell
12400 high bluff drive
san diego, CA 92130
+1(858)224-6281
MDR Report Key50913146
Report Number3013756811-2026-175669
Device Sequence Number5370132
Product Code QFG
UDI-Device Identifier00389152408170
UDI-Public00389152408170
Combination Product (Y/N)N
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
K240309
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Type of Report Initial
Report Date (Section B) 09/28/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Lay User/Patient
Device Model Number1004000
Device Catalogue Number1014081
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/23/2026
Initial Report FDA Received Date09/28/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured12/17/2024
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient Age40 YR
Patient SexFemale
Patient Weight138 LB
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