FDA Adverse Event Malfunction Summary report: N

DEXCOM G6 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 21610276 · Received March 14, 2025

Report

Report Number
3004753838-2025-062319
Event Type
Malfunction
Date Received
March 14, 2025
Date of Event
February 23, 2025
Report Date
May 22, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
PMA / PMN Number
DEN170088
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4). H2: CORRECTION. MFR (3004753838-2025-062319) 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

SUBSEQUENT TO THE INITIAL MDR, ADDITIONAL INFORMATION IS REQUIRED.

Description of Event or Problem · 0

IT WAS REPORTED THAT NO ALERT/NOTIFICATION OCCURRED. THE PERFORMANCE DATA WAS EVALUATED. THE ALLEGATION WAS CONFIRMED AS NO AUDIO OUTPUT. THE PROBABLE CAUSE OF NO AUDIO OUTPUT 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
796644 DEXCOM G6 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC.

Patients

Seq Age Sex Outcome Treatment
1 54 YR Female INSULIN PUMP.