inforMED
MalfunctionPQM

DEXCOM G5 MOBILE CONTINUOUS GLUCOSE MONITORING SYSTEM

Received Jan 16, 2018 · Event occurred Dec 9, 2017

Report 3004753838-2018-005655 · MDR key 7195674

Device

Generic name

Continuous Glucose Monitor

Manufacturer

Dexcom, Inc.

Model number

N/A

Catalog number

SW10611

Product problems

  • Wireless Communication Problem
  • Wireless Communication Problem

Patient

21 YR

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

THE PATIENT EXPERIENCED ADVERSE EVENTS ON DIFFERENT DAYS WITH THE SAME DEVICE. THE FOLLOWING REPORTS ARE BEING SUBMITTED: (B)(4).

Description of Event or Problem

DEXCOM WAS MADE AWARE ON (B)(4) 2017 THAT ON (B)(6) 2017, A LOSS OF CONNECTION BETWEEN THE TRANSMITTER AND SMART DEVICE OCCURRED. NO ADDITIONAL PATIENT OR EVENT INFORMATION IS AVAILABLE. DATA WAS RETURNED AND EVALUATED. THE REPORTED EVENT OF A LOSS OF CONNECTION WAS CONFIRMED VIA DATA. A ROOT CAUSE COULD NOT BE DETERMINED.