FDA Adverse Event Malfunction Summary report: N

DEXCOM G6 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 21332405 · Received February 7, 2025

Report

Report Number
3004753838-2025-032564
Event Type
Malfunction
Date Received
February 7, 2025
Date of Event
January 9, 2025
Report Date
March 31, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270003232
PMA / PMN Number
DEN170088
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WY, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4). 3004753838-2025-032564 WAS REPORTED IN ERROR. PLEASE DISREGARD INITIAL REPORTING OF THIS EVENT AS THIS EVENT HAS NOW BEEN DEEMED NOT REPORTABLE.

Additional Manufacturer Narrative · 0

(B)(4). 3004753838-2025-032564 WAS REPORTED IN ERROR. PLEASE DISREGARD INITIAL REPORTING OF THIS EVENT AS THIS EVENT HAS NOW BEEN DEEMED NOT REPORTABLE.

Additional Manufacturer Narrative · 0

(B)(4).

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.

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.

Description of Event or Problem · 0

IT WAS REPORTED THAT A RECEIVER REINITIALIZATION OCCURRED. PRODUCT HAS BEEN RECEIVED BUT IS PENDING EVALUATION. A FOLLOW UP REPORT WILL BE SUBMITTED UPON COMPLETION. NO INJURY OR MEDICAL INTERVENTION WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
701255 DEXCOM G6 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. P16517644 00386270003232

Patients

Seq Age Sex Outcome Treatment
1 58 YR Female