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

Model Number	1004000
Medical Device Problem Code	Pumping Stopped (1503)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	09/26/2026
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that pump displayed malfunction alarm code 12, which could be reset but alarm recurred after reset.There was no adverse impact to the customer¿s blood glucose level.Customer switched to multiple daily injections as backup insulin therapy, received guidance to reset pump, and was sent replacement pump with updated software; customer was instructed to put pump into storage mode, return problematic pump within 10 days using provided materials, and then program pump settings and reconnect continuous glucose monitor on replacement pump.
Additional Manufacturer Narrative
In use at the time of the event: cgm model: unknown.Mobile os: ios / ios_iphone 12 / ios_16.1.1.

• 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 Key: 50930837
• Report Number: 3013756811-2026-176626
• Device Sequence Number: 9508927
• Product Code: QFG
• UDI-Device Identifier: 00389152370019
• UDI-Public: (01)00389152370019(22)1013701(11)240605
• Combination Product (Y/N): N
• Initial Reporter State: MA
• Initial Reporter Country: US
• PMA/510(K) Number: K233044
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Consumer
• Type of Report: Initial
• Report Date (Section B): 09/29/2026

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 Number: 1004000
• Device Catalogue Number: 1013700
• 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: 09/26/2026
• Initial Report FDA Received Date: 09/29/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 06/05/2024
• 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 Number: 1
• Patient Age: 18 YR
• Patient Sex: Unknown