FDA Adverse Event Malfunction Summary report: N

DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 21085764 · Received January 6, 2025

Report

Report Number
3004753838-2025-003335
Event Type
Malfunction
Date Received
January 6, 2025
Date of Event
December 9, 2024
Report Date
October 9, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
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). 3004753838-2025-003335 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

PRODUNCT HAS BEEN RETURNED AND THE INVESTIGATION IS BEING REVIEWED. A SUPPLEMENTAL REPORT WILL BE SUBMITTED AFTER THE REVIEW IS COMPLETE.

Description of Event or Problem · 0

AFTER SUBMISSION OF THE INITIAL MDR, PRODUCT WAS RECEIVED ON 12/20/2024 AND IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
950159 DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 9500-161 1724281001

Patients

Seq Age Sex Outcome Treatment
1 67 YR Female