FDA Adverse Event Malfunction Summary report: N

DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 21061588 · Received January 2, 2025

Report

Report Number
3004753838-2025-000731
Event Type
Malfunction
Date Received
January 2, 2025
Date of Event
December 9, 2024
Report Date
June 10, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270003935
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). MFR # 3004753838-2025-000731 WAS REPORTED IN ERROR. PLEASE DISREGARD INITIAL REPORTING OF THIS EVENT AS THIS EVENT HAS NOW BEEN DEEMED NOT REPORTABLE.

Description of Event or Problem · 0

IT WAS REPORTED THAT A DETACHED OR MISSING SENSOR WIRE OCCURRED. THE SENSOR WAS INSERTED INTO THE ABDOMEN, WHICH IS OFF LABEL USAGE OF THE DEVICE, ON (B)(6) 2024. 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

SUBSEQUENT TO THE INITIAL MDR, IT WAS DETERMINED THAT A REPORT WAS SUBMITTED IN ERROR. UPON FURTHER REVIEW, IT WAS DETERMINED THAT THE PATIENT ALLEGATION DOES NOT MEET THE CRITERIA OF A REPORTABLE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1610628 DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 9500-161 1824186003 00386270003935

Patients

Seq Age Sex Outcome Treatment
1 78 YR Female