FDA Adverse Event Malfunction Summary report: N

DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 22197484 · Received June 12, 2025

Report

Report Number
3004753838-2025-150837
Event Type
Malfunction
Date Received
June 12, 2025
Date of Event
May 13, 2025
Report Date
October 7, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270003935
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). 3004753838-2025-150837 WAS REPORTED IN ERROR. PLEASE DISREGARD INITIAL REPORTING OF THIS EVENT AS THIS EVENT HAS NOW BEEN DEEMED NOT REPORTABLE.

Additional Manufacturer Narrative · 0

(B)(4)

Description of Event or Problem · 0

AFTER SUBMISSION OF THE INITIAL MDR PRODUCT WAS RECEIVED ON 6/18/2025 IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER CORPFT-140202.

Description of Event or Problem · 0

IT WAS REPORTED THAT A DETACHED NEEDLE OR CANNULA 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.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1779434 DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 9500-161 1825046001 00386270003935

Patients

Seq Age Sex Outcome Treatment
1 69 YR Male LANTUS INSULIN PEN