FDA Adverse Event Malfunction Summary report: N

DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 19008768 · Received March 29, 2024

Report

Report Number
3004753838-2024-074134
Event Type
Malfunction
Date Received
March 29, 2024
Date of Event
February 4, 2024
Report Date
May 16, 2024
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270002525
PMA / PMN Number
K213919
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT AN ALERT/NOTIFICATION SETTINGS ISSUE OCCURRED. NO PRODUCT OR DATA WAS PROVIDED FOR EVALUATION. THE ALLEGATION AND A PROBABLE CAUSE COULD NOT BE DETERMINED. NO INJURY OR MEDICAL INTERVENTION WAS REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT AN ALERT/NOTIFICATION SETTINGS ISSUE OCCURRED. THE PRODUCT WAS EVALUATED. AN EXTERIOR VISUAL INSPECTION WAS PERFORMED AND PASSED. A RECEIVER CHARGE WAS PERFORMED AND PASSED. A RECEIVER BOOT TEST WAS PERFORMED AND PASSED. FUNCTIONAL TESTS WERE PERFORMED AND FAILED DUE TO FAILED SERIAL NUMBER VERIFICATION. ALARM/ALERT MANUAL TEST WAS PERFORMED AND FAILED DUE TO LOW SOUND. SPEAKER/VIBRATOR RESISTANCE MEASURED WAS PERFORMED AND PASSED. INTERNAL VISUAL INSPECTION WAS PERFORMED AND FAILED DUE TO FOREIGN OBJECT DAMAGE TO SPEAKER/FOD. THE PERFORMANCE DATA WAS REVIEWED FINDING ERRORS RELATED TO THE COMPLAINT. THE ALLEGATION WAS CONFIRMED AS LOW AUDIO OUTPUT VIA PRODUCT. THE PROBABLE CAUSE WAS DETERMINED TO BE A DEFECTIVE SPEAKER VIA PRODUCT. NO INJURY OR MEDICAL INTERVENTION WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2582881 DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. MT26403-0 P16494903 00386270002525

Patients

Seq Age Sex Outcome Treatment
1 81 YR Male