FDA Adverse Event Malfunction Summary report: N

DEXCOM G6 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 21333584 · Received February 7, 2025

Report

Report Number
3004753838-2025-032709
Event Type
Malfunction
Date Received
February 7, 2025
Date of Event
January 21, 2025
Report Date
September 23, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270001788
PMA / PMN Number
DEN170088
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4). 3004753838-2025-032709 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 SIGNAL LOSS 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

AFTER SUBMISSION OF THE INITIAL MDR PRODUCT WAS RECEIVED ON 8/19/2025 IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER CORPFT-140202.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
866850 DEXCOM G6 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 18365012 00386270001788

Patients

Seq Age Sex Outcome Treatment
1 73 YR Female INSULET OMNIPOD5