DEXCOM G5 MOBILE CONTINUOUS GLUCOSE MONITORING SYSTEM 9438-06 STT-GF-001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2018-02-15 for DEXCOM G5 MOBILE CONTINUOUS GLUCOSE MONITORING SYSTEM 9438-06 STT-GF-001 manufactured by Dexcom, Inc..

Event Text Entries

[100174572] (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[100174573] Dexcom was made aware on (b)(4) 2017, that on (b)(6) 2017, the smart device displayed an error message for low transmitter battery. Data was provided for evaluation. Data review confirmed the reported event of low transmitter battery. A probable cause could not be determined via data. This complaint is reportable based on the finding of transmitter failure error via log data review. No product was provided for evaluation. No additional patient or event information is available.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004753838-2018-016782
MDR Report Key7273325
Report SourceCONSUMER
Date Received2018-02-15
Date of Report2018-01-17
Date of Event2017-12-28
Date Mfgr Received2018-01-17
Device Manufacturer Date2017-04-26
Date Added to Maude2018-02-15
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR KIPP DURBIN
Manufacturer Street6340 SEQUENCE DR.
Manufacturer CitySAN DIEGO CA 92121
Manufacturer CountryUS
Manufacturer Postal92121
Manufacturer Phone8582000200
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Sequence Number: 0

Brand NameDEXCOM G5 MOBILE CONTINUOUS GLUCOSE MONITORING SYSTEM
Generic NameCONTINUOUS GLUCOSE MONITOR
Product CodePQF
Date Received2018-02-15
Model Number9438-06
Catalog NumberSTT-GF-001
Lot Number6002684
OperatorLAY USER/PATIENT
Device AvailabilityY
Device Eval'ed by MfgrN
Device Sequence No0
Device Event Key0
ManufacturerDEXCOM, INC.
Manufacturer Address6340 SEQUENCE DR. SAN DIEGO CA 92121 US 92121

Device Sequence Number: 1

Brand NameDEXCOM G5 MOBILE CONTINUOUS GLUCOSE MONITORING SYSTEM
Generic NameCONTINUOUS GLUCOSE MONITOR
Product CodePFQ
Date Received2018-02-15
Model Number9438-06
Catalog NumberSTT-GF-001
Lot Number6002684
OperatorLAY USER/PATIENT
Device AvailabilityY
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerDEXCOM, INC.
Manufacturer Address6340 SEQUENCE DR. SAN DIEGO CA 92121 US 92121


Patients

Patient NumberTreatmentOutcomeDate
10 2018-02-15

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