DEXCOM G5 MOBILE CONTINUOUS GLUCOSE MONITORING SYSTEM 9500-27 STS-GL-011

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 2020-03-31 for DEXCOM G5 MOBILE CONTINUOUS GLUCOSE MONITORING SYSTEM 9500-27 STS-GL-011 manufactured by Dexcom, Inc..

Event Text Entries

[185778859] (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[185778860] It was reported that a no readings event occurred. Data was evaluated and the allegation was confirmed as signal loss over one hour. The probable cause of the signal loss could not be determined. The reported event of a no readings event is reportable based on the finding of signal loss over one hour. No injury or medical intervention was reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004753838-2020-030899
MDR Report Key9905494
Report SourceCONSUMER
Date Received2020-03-31
Date of Report2020-03-31
Date of Event2020-03-17
Date Mfgr Received2020-03-31
Date Added to Maude2020-03-31
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS ASHLEY SPOTO
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 Details

Brand NameDEXCOM G5 MOBILE CONTINUOUS GLUCOSE MONITORING SYSTEM
Generic NameCONTINUOUS GLUCOSE MONITOR
Product CodePQF
Date Received2020-03-31
Model Number9500-27
Catalog NumberSTS-GL-011
Lot NumberNI
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDEXCOM, INC.
Manufacturer Address6340 SEQUENCE DR. SAN DIEGO CA 92121 US 92121


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-31

© 2024 FDA.report
This site is not affiliated with or endorsed by the FDA.