FDA Adverse Event Malfunction Summary report: N

DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 22810154 · Received August 14, 2025

Report

Report Number
3004753838-2025-223369
Event Type
Malfunction
Date Received
August 14, 2025
Date of Event
August 10, 2025
Report Date
September 25, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270003935
PMA / PMN Number
K213919
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4). MFR NO 3004753838-2025-223369 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 8/25/2025 AND IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED BROKEN SENSOR WIRE. THE SENSOR WAS INSERTED SHOULDER WHICH IS OFF LABEL USAGE OF THE DEVICE 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
1557819 DEXCOM G7 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 9500-161 1825133005 00386270003935

Patients

Seq Age Sex Outcome Treatment
1 81 YR Male