FDA Adverse Event Malfunction Summary report: N

DEXCOM G6 CONTINUOUS GLUCOSE MONITORING SYSTEM

MDR report key: 8408466 · Received March 11, 2019

Report

Report Number
3004753838-2019-024743
Event Type
Malfunction
Date Received
March 11, 2019
Date of Event
February 19, 2019
Report Date
March 11, 2019
Manufacturer
DEXCOM, INC.
Product Code
QBJ
UDI-DI
00386270000385
PMA / PMN Number
DEN170088
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

DEXCOM WAS MADE AWARE ON 02/19/2019 THAT THE DISPLAY DEVICE SHOWED A TRANSMITTER FAILED ERROR ON 02/19/2019. DATA WAS RETURNED AND EVALUATED. THE REPORTED EVENT OF A TRANSMITTER FAILED ERROR WAS CONFIRMED VIA DATA. A PROBABLE CAUSE COULD NOT BE DETERMINED. NO ADDITIONAL PATIENT OR EVENT INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
200509 DEXCOM G6 CONTINUOUS GLUCOSE MONITORING SYSTEM CONTINUOUS GLUCOSE MONITOR QBJ DEXCOM, INC. 9445-02 5246021 00386270000385

Patients

Seq Age Sex Outcome Treatment
1 40 YR