FDA Adverse Event Malfunction Summary report: N

DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 22154781 · Received June 5, 2025

Report

Report Number
3004753838-2025-142298
Event Type
Malfunction
Date Received
June 5, 2025
Date of Event
May 7, 2025
Report Date
September 29, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270004109
PMA / PMN Number
K213919
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4). 3004753838-2025-142298 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 ARM ON (B)(6) 2025. 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 5/29/2025, AND IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1492959 DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 9500-161 1825104004 00386270004109

Patients

Seq Age Sex Outcome Treatment
1 70 YR Male HUMALOG.