Tandem Mobi insulin pump with interoperable technology

K240309 · Tandem Diabetes Care, Inc. · QFG · Mar 21, 2024 · Clinical Chemistry

Device Facts

Record IDK240309
Device NameTandem Mobi insulin pump with interoperable technology
ApplicantTandem Diabetes Care, Inc.
Product CodeQFG · Clinical Chemistry
Decision DateMar 21, 2024
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 880.5730
Device ClassClass 2
AttributesTherapeutic, Pediatric

Indications for Use

The Tandem Mobi insulin pump with interoperable technology (the pump) is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin. The pump is able to reliably and securely communicate with compatible, digitally connected devices, including automated insulin dosing software, to receive, execute, and confirm commands from these devices. The pump is intended for single patient, home use and requires a prescription.

Device Story

Tandem Mobi is an Alternate Controller Enabled (ACE) insulin pump; screenless design with LED, sound, and vibratory status indicators. Operates via Tandem Mobi Mobile Application; app serves as primary controller for programming basal/bolus delivery, managing profiles, and viewing CGM/pump data. Communicates via Bluetooth Low Energy (BLE) with compatible iCGMs and interoperable automated glycemic controllers (iAGC). Used in home settings by patients; transmits therapy data to Tandem Cloud. Benefits include automated insulin delivery management and expanded age indication (≥2 years).

Clinical Evidence

No clinical data provided. Substantial equivalence supported by bench testing leveraged from K223213, human factors analysis, and software verification/validation.

Technological Characteristics

Ambulatory, battery-operated, rate-programmable infusion pump. Motor-driven delivery mechanism. Connectivity via Bluetooth Low Energy (BLE). Visual, audible, and vibratory alarm system. Disposable 2mL cartridge (Ethylene Oxide sterilized, SAL 10^-6). Non-sterile pump housing. Compatible with U-100 insulin and FDA-cleared infusion sets with t:lock connectors.

Indications for Use

Indicated for management of diabetes mellitus in individuals 2 years of age and greater requiring insulin therapy via subcutaneous delivery.

Regulatory Classification

Identification

An alternate controller enabled infusion pump (ACE pump) is a device intended for the infusion of drugs into a patient. The ACE pump may include basal and bolus drug delivery at set or variable rates. ACE pumps are designed to reliably and securely communicate with external devices, such as automated drug dosing systems, to allow drug delivery commands to be received, executed, and confirmed. ACE pumps are intended to be used both alone and in conjunction with digitally connected medical devices for the purpose of drug delivery.

Special Controls

Alternate controller enabled infusion pumps must comply with the following special controls:

*Classification.* Class II (special controls). The special controls for this device are:(1) Design verification and validation must include the following: (i) Evidence demonstrating that device infusion delivery accuracy conforms to defined user needs and intended uses and is validated to support safe use under actual use conditions. (A) Design input requirements must include delivery accuracy specifications under reasonably foreseeable use conditions, including ambient temperature changes, pressure changes ( *e.g.,* head-height, backpressure, atmospheric), and, as appropriate, different drug fluidic properties.(B) Test results must demonstrate that the device meets the design input requirements for delivery accuracy under use conditions for the programmable range of delivery rates and volumes. Testing shall be conducted with a statistically valid number of devices to account for variation between devices. (ii) Validation testing results demonstrating the ability of the pump to detect relevant hazards associated with drug delivery and the route of administration ( *e.g.,* occlusions, air in line, etc.) within a clinically relevant timeframe across the range of programmable drug delivery rates and volumes. Hazard detection must be appropriate for the intended use of the device and testing must validate appropriate performance under the conditions of use for the device.(iii) Validation testing results demonstrating compatibility with drugs that may be used with the pump based on its labeling. Testing must include assessment of drug stability under reasonably foreseeable use conditions that may affect drug stability ( *e.g.,* temperature, light exposure, or other factors as needed).(iv) The device parts that directly or indirectly contact the patient must be demonstrated to be biocompatible. This shall include chemical and particulate characterization on the final, finished, fluid contacting device components demonstrating that risk of harm from device-related residues is reasonably low. (v) Evidence verifying and validating that the device is reliable over the ACE pump use life, as specified in the design file, in terms of all device functions and in terms of pump performance. (vi) The device must be designed and tested for electrical safety, electromagnetic compatibility, and radio frequency wireless safety and availability consistent with patient safety requirements in the intended use environment. (vii) For any device that is capable of delivering more than one drug, the risk of cross-channeling drugs must be adequately mitigated. (viii) For any devices intended for multiple patient use, testing must demonstrate validation of reprocessing procedures and include verification that the device meets all functional and performance requirements after reprocessing. (2) Design verification and validation activities must include appropriate design inputs and design outputs that are essential for the proper functioning of the device that have been documented and include the following: (i) Risk control measures shall be implemented to address device system hazards and the design decisions related to how the risk control measures impact essential performance shall be documented. (ii) A traceability analysis demonstrating that all hazards are adequately controlled and that all controls have been validated in the final device design. (3) The device shall include validated interface specifications for digitally connected devices. These interface specifications shall, at a minimum, provide for the following: (i) Secure authentication (pairing) to external devices. (ii) Secure, accurate, and reliable means of data transmission between the pump and connected devices. (iii) Sharing of necessary state information between the pump and any digitally connected alternate controllers ( *e.g.,* battery level, reservoir level, pump status, error conditions).(iv) Ensuring that the pump continues to operate safely when data is received in a manner outside the bounds of the parameters specified. (v) A detailed process and procedure for sharing the pump interface specification with digitally connected devices and for validating the correct implementation of that protocol. (4) The device must include appropriate measures to ensure that safe therapy is maintained when communications with digitally connected alternate controller devices is interrupted, lost, or re-established after an interruption ( *e.g.,* reverting to a pre-programmed, safe drug delivery rate). Validation testing results must demonstrate that critical events that occur during a loss of communications (*e.g.,* commands, device malfunctions, occlusions, etc.) are handled appropriately during and after the interruption.(5) The device design must ensure that a record of critical events is stored and accessible for an adequate period to allow for auditing of communications between digitally connected devices and to facilitate the sharing of pertinent information with the responsible parties for those connected devices. Critical events to be stored by the system must, at a minimum, include: (i) A record of all drug delivery (ii) Commands issued to the pump and pump confirmations (iii) Device malfunctions (iv) Alarms and alerts and associated acknowledgements (v) Connectivity events ( *e.g.,* establishment or loss of communications)(6) Design verification and validation must include results obtained through a human factors study that demonstrates that an intended user can safely use the device for its intended use. (7) Device labeling must include the following: (i) A prominent statement identifying the drugs that are compatible with the device, including the identity and concentration of those drugs as appropriate. (ii) A description of the minimum and maximum basal rates, minimum and maximum bolus volumes, and the increment size for basal and bolus delivery, or other similarly applicable information about drug delivery parameters. (iii) A description of the pump accuracy at minimum, intermediate, and maximum bolus delivery volumes and the method(s) used to establish bolus delivery accuracy. For each bolus volume, pump accuracy shall be described in terms of the number of bolus doses measured to be within a given range as compared to the commanded volume. An acceptable accuracy description (depending on the drug delivered and bolus volume) may be provided as follows for each bolus volume tested, as applicable: Number of bolus doses with volume that is <25 percent, 25 percent to <75 percent, 75 percent to <95 percent, 95 percent to <105 percent, 105 percent to <125 percent, 125 percent to <175 percent, 175 to 250 percent, and >250 percent of the commanded amount. (iv) A description of the pump accuracy at minimum, intermediate, and maximum basal delivery rates and the method(s) used to establish basal delivery accuracy. For each basal rate, pump accuracy shall be described in terms of the amount of drug delivered after the basal delivery was first commanded, without a warmup period, up to various time points. The information provided must include typical pump performance, as well as worst-case pump performance observed during testing in terms of both over-delivery and under-delivery. An acceptable accuracy description (depending on the drug delivered) may be provided as follows, as applicable: The total volume delivered 1 hour, 6 hours, and 12 hours after starting delivery for a typical pump tested, as well as for the pump that delivered the least and the pump that delivered the most at each time point. (v) A description of delivery hazard alarm performance, as applicable. For occlusion alarms, performance shall be reported at minimum, intermediate, and maximum delivery rates and volumes. This description must include the specification for the longest time period that may elapse before an occlusion alarm is triggered under each delivery condition, as well as the typical results observed during performance testing of the pumps. (vi) For wireless connection enabled devices, a description of the wireless quality of service required for proper use of the device. (vii) For any infusion pumps intended for multiple patient reuse, instructions for safely reprocessing the device between uses.

Predicate Devices

Related Devices

Submission Summary (Full Text)

{0} FDA U.S. FOOD &amp; DRUG ADMINISTRATION # 510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY ## I Background Information: A 510(k) Number K240309 B Applicant Tandem Diabetes Care, Inc C Proprietary and Established Names Tandem Mobi insulin pump with interoperable technology D Regulatory Information | Product Code(s) | Classification | Regulation Section | Panel | | --- | --- | --- | --- | | QFG | Class II | 21 CFR 880.5730 – Alternate Controller Enabled Infusion Pump | CH - Clinical Chemistry | ## E Purpose for Submission: Modification to a cleared device to expand the age indication (from ≥ 6 years old to ≥ 2 years old), and to add a new mobile app unique to the Mobi pump. ## II Intended Use/Indications for Use: A Intended Use(s): See Indications for Use below. B Indication(s) for Use: The Tandem Mobi Insulin Pump with interoperable technology (the pump) is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin. The pump is able to reliably and securely communicate Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993-0002 www.fda.gov {1} with compatible, digitally connected devices, including automated insulin dosing software, to receive, execute, and confirm commands from these devices. The pump is intended for single patient, home use and requires a prescription. The pump is indicated for use in individuals two years of age and greater. ## C Special Conditions for Use Statement(s): Rx - For Prescription Use Only The Tandem Mobi insulin pump is not intended for anyone unable or unwilling to: - Use the pump, CGM, and all other system components in accordance with their respective instructions for use. - Test blood glucose (BG) levels as recommended by their healthcare provider. - Maintain sufficient diabetes self-care skills. - See their healthcare team regularly. - Demonstrate adequate carbohydrate-counting skills. The user must also have adequate vision and/or hearing in order to recognize all functions of the pump, including alerts, alarms, and reminders. The pump is magnetic resonance (MR) unsafe. You must take off your pump, transmitter, and sensor and leave them outside the procedure room. Do not expose your pump, transmitter, or sensor to X-ray, CT, MRI, PET, or other exposure to radiation. Some skin care products such as lotions, sunscreens, and insect repellents can cause cracks in the plastic used to manufacture the pump and cartridge. DO NOT allow these products to come in contact with the pump or cartridge. ALWAYS remove your pump before applying these products and ALWAYS wash your hands before handling your pump or cartridge after using such products. ALWAYS change your cartridge if it becomes exposed to such products and immediately clean your pump. Failure to do so may result in damage to the pump and cartridge and in some cases over or under delivery of insulin. The Tandem Mobi insulin pump with interoperable technology and the Tandem Mobi Cartridge are compatible with the following U-100 insulins: Humalog and Novolog. ## III Device Description: The Subject Device, Tandem Mobi insulin pump with interoperable technology ("Mobi pump", "the pump"), is an Alternate Controller Enabled (ACE) Infusion Pump intended for the infusion of insulin into a patient requiring insulin therapy. The Tandem Mobi insulin pump with interoperable technology ("pump") is screenless and includes visual LED, sound, and vibratory indicators to alert the user of the pump status. The Tandem Mobi insulin pump with interoperable technology system also includes: the Tandem Mobi Mobile Application and a 2mL (200 insulin unit) Tandem Mobi cartridge and a compatible FDA cleared infusion set. K240309 - Page 2 of 5 {2} The Tandem Mobi Mobile Application (“Mobile app”) displays all information from, and is the primary controller of, the pump. Through the Mobile app, users will program all aspects of basal and bolus insulin delivery therapy including managing personal profiles, viewing pump and CGM data, and actively acknowledging all pump and mobile app alerts, alarms, reminders, notifications, and messages. The Tandem Mobi Mobile Application will also be used to transmit historical pump and mobile app therapy data to the Tandem Cloud. The Tandem Mobi Mobile Application will be made available via the Apple® App Store for iOS compatible smartphones based on completed device verification and validation. The Tandem Mobi cartridge is a disposable insulin cartridge compatible only with the Tandem Mobi pump. The pump may be used in combination with a compatible integrated continuous glucose monitor (iCGM) system or with compatible interoperable automated glycemic controllers (iAGC). Use of iCGM and iAGC is optional. ## IV Substantial Equivalence Information: ### A Predicate Device Name(s): Tandem Mobi insulin pump with interoperable technology ### B Predicate 510(k) Number(s): K233044 ### C Comparison with Predicate(s): | Device & Predicate Device(s): | K240309 | K233044 (predicate) | | --- | --- | --- | | Device Trade Name | Tandem Mobi Insulin Pump with interoperable technology | Tandem Mobi Insulin Pump with interoperable technology | | General Device Characteristic Similarities | | | | Intended Use | Intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin. Intended to be interoperable with connected devices including CGMs and automated insulin | Same | K240309 - Page 3 of 5 {3} | | dosing algorithms. | | | --- | --- | --- | | Insulin Type | NovoLog or Humalog U-100 insulin | Same | | Communication with Compatible Interoperable Devices | Bluetooth Low Energy (BLE) | Same | | General Device Characteristic Differences | | | | Intended Population | Individuals two years of age and greater | Individuals six years of age and greater | | Primary Controller | Tandem Mobi Mobile Application | t:connect Mobile App | V Standards/Guidance Documents Referenced: ISO 14971 Third Edition 2019-12: Medical Devices - Application of risk management to medical devices FDA Recognition no: 5-125 IEC 62304 Edition 1.1 2015-06 CONSOLIDATED VERSION: Medical device software – Software life cycle processes FDA Recognition no: 13-79 VI Performance Characteristics: A Analytical Performance: Bench testing data is leveraged from K223213. B Other Supportive Instrument Performance Characteristics Data: Human Factors: A comparative Use Related Risk Analysis was performed to support leveraging human factors validation testing from K223213. Software Verification and Validation Detailed information on software of the device was reviewed and found acceptable. Cybersecurity: Tandem has provided cybersecurity risk management documentation based on the National Institute of Standards and Technology, medical Device Privacy Consortium, FDA guidelines, and the Open Web Application Security Project. Cybersecurity documentation includes assessment of the threat model, vulnerabilities, SBOM, and penetration testing. The cybersecurity was reviewed and found to be acceptable. VII Proposed Labeling: The labeling supports the finding of substantial equivalence for this device. K240309 - Page 4 of 5 {4} K240309 - Page 5 of 5 VIII Conclusion: The submitted information in this premarket notification is complete and supports a substantial equivalence decision.
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