FDA Adverse Event Malfunction Summary report: N

DEXCOM G6 GLUCOSE PROGRAM CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 23001356 · Received September 9, 2025

Report

Report Number
3004753838-2025-250481
Event Type
Malfunction
Date Received
September 9, 2025
Date of Event
July 7, 2025
Report Date
September 23, 2025
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270001771
PMA / PMN Number
K182041
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4). 3004753838-2025-250481 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). B5: DESCRIBE EVENT OR PROBLEM - ADDITIONAL INFORMATION. H2 TYPE OF FOLLOW UP: ADDITIONAL INFORMATION. H3: DEVICE EVALUATED BY MFG - ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 0

(B)(4).

Description of Event or Problem · 0

AFTER SUBMISSION OF THE INITIAL MDR, PRODUCT WAS RECEIVED ON 8/27/2025 AND IT WAS DETERMINED THIS COMPLAINT IS NOT REPORTABLE PER CORPFT-140202.

Description of Event or Problem · 0

IT WAS REPORTED THAT SIGNAL LOSS OCCURRED. PRODUCT HAS BEEN RETURNED AND THE INVESTIGATION IS BEING REVIEWED. A FOLLOW UP REPORT WILL BE SUBMITTED UPON COMPLETION. NO INJURY OR MEDICAL INTERVENTION WAS REPORTED

Description of Event or Problem · 0

IT WAS REPORTED THAT A DETACHED OR MISSING SENSOR WIRE OCCURRED. PRODUCT HAS BEEN RETURNED AND THE INVESTIGATION IS BEING REVIEWED. A SUPPLEMENTAL REPORT WILL BE SUBMITTED AFTER THE REVIEW IS COMPLETE. NO INJURY OR MEDICAL INTERVENTION WAS REPORTED

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2066015 DEXCOM G6 GLUCOSE PROGRAM CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 20471730 00386270001771

Patients

Seq Age Sex Outcome Treatment
1 36 YR Male TANDEM TSLIM