FDA Adverse Event Malfunction Summary report: N

DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 21227775 · Received January 24, 2025

Report

Report Number
3004753838-2025-020758
Event Type
Malfunction
Date Received
January 24, 2025
Date of Event
January 5, 2025
Report Date
July 21, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270003584
PMA / PMN Number
K213919
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4). 3004753838-2025-020758 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 01-05-2025. 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

AFTER SUBMISSION OF THE INITIAL MDR PRODUCT WAS RECEIVED ON 2/11/2025 IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER CORPFT-140202.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
630423 DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 9500-161 1824199001 00386270003584

Patients

Seq Age Sex Outcome Treatment
1 78 YR Male