FDA Adverse Event Malfunction Summary report: N

STELO GLUCOSE BIOSENSOR SYSTEM

MDR report key: 22777787 · Received August 11, 2025

Report

Report Number
3004753838-2025-218180
Event Type
Malfunction
Date Received
August 11, 2025
Date of Event
July 22, 2025
Report Date
October 15, 2025
Manufacturer
DEXCOM, INC.
Product Code
SAF
UDI-DI
00386270004338
PMA / PMN Number
K234070
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

(B)(4). 3004753838-2025-218180 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 BACK OF UPPER ARM ON (B)(6) 2025. DATA WAS RECEIVED BUT NOT INVESTIGATED AS DATA WILL NOT CONFIRM THE ISSUE. 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 7/29/2025 AND IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER CORPFT-140202.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2159859 STELO GLUCOSE BIOSENSOR SYSTEM CONTINUOUS GLUCOSE MONITOR SAF DEXCOM, INC. 9500-174 1725102004 00386270004338

Patients

Seq Age Sex Outcome Treatment
1 70 YR Female