FDA Adverse Event Malfunction Summary report: N

DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 21786439 · Received April 7, 2025

Report

Report Number
3004753838-2025-080561
Event Type
Malfunction
Date Received
April 7, 2025
Date of Event
March 9, 2025
Report Date
August 12, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
PMA / PMN Number
K213919
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4). A4 WEIGHT - CORRECTION. A4 WEIGHT UNITS - CORRECTION. B5 DESCRIBE EVENT OR PROBLEM - ADDITIONAL INFORMATION. G3 DATE RECEIVED BY MFG - ADDITIONAL INFORMATION. G6 TYPE OF REPORT - UPDATED/FOLLOW-UP. H2 TYPE OF FOLLOW UP - ADDITIONAL INFORMATION/CORRECTION. H10 CORRECTED DATA.

Additional Manufacturer Narrative · 0

(B)(4). 3004753838-2025-080561 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 (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, A CORRECTION IS REQUIRED.

Description of Event or Problem · 0

AFTER SUBMISSION OF THE INITIAL MDR, PRODUCT WAS RECEIVED ON 3/31/2025 AND IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER CORPFT-140202.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1846685 DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 9500-161 1824337004

Patients

Seq Age Sex Outcome Treatment
1 85 YR Male