FDA Adverse Event Malfunction Summary report: N

DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 21785715 · Received April 7, 2025

Report

Report Number
3004753838-2025-080405
Event Type
Malfunction
Date Received
April 7, 2025
Date of Event
March 9, 2025
Report Date
August 13, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
PMA / PMN Number
K213919
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4). 3004753838-2025-080405 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 DETACHED NEEDLE OR CANNULA OCCURRED. THE SENSOR WAS INSERTED INTO THE ARM ON (B)(6) 2025. PRODUCT HAS BEEN RECEIVED BUT IS PENDING EVALUATION. A FOLLOW UP REPORT WILL BE SUBMITTED UPON COMPLETION. 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
1445054 DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 9500-161 1824317004

Patients

Seq Age Sex Outcome Treatment
1 87 YR Male LANTUS PEN.