FDA Adverse Event Malfunction Summary report: N

DEXCOM G6 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 22715145 · Received August 5, 2025

Report

Report Number
3004753838-2025-210151
Event Type
Malfunction
Date Received
August 5, 2025
Date of Event
July 11, 2025
Report Date
August 19, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270001788
PMA / PMN Number
DEN170088
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). 3004753838-2025-210151 WAS REPORTED IN ERROR. PLEASE DISREGARD INITIAL REPORTING OF THIS EVENT AS THIS EVENT HAS NOW BEEN DEEMED NOT REPORTABLE. G3 DATE RECEIVED BY MFG- ADDITIONAL INFORMATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT SIGNAL LOSS OVER ONE HOUR OCCURRED. PRODUCT HAS BEEN RECEIVED BUT IS PENDING EVALUATION. A FOLLOW-UP WILL BE SUBMITTED UPON COMPLETION. NO INJURY OR MEDICAL INTERVENTION WAS REPORTED.

Description of Event or Problem · 0

AFTER SUBMISSION OF THE INITIAL MDR PRODUCT WAS RECEIVED ON 7/23/2025 IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2684807 DEXCOM G6 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 19928434 00386270001788

Patients

Seq Age Sex Outcome Treatment
1 71 YR Male INSULET OMNIPOD 5