inforMED
MalfunctionPFQ

DEXCOM G5 MOBILE CONTINUOUS GLUCOSE MONITORING SYSTEM

Received Aug 1, 2018 · Event occurred Jun 26, 2018

Report 3004753838-2018-078471 · MDR key 7741635

Device

Generic name

Continuous Glucose Monitor

Manufacturer

Dexcom, Inc.

Model number

9438-06

Catalog number

STT-GF-001

Lot number

6006057

Product problems

  • Connection Problem
  • Connection Problem

Patient

33 YR

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

Narrative

Additional Manufacturer Narrative

(B)(4).

Description of Event or Problem

DEXCOM WAS MADE AWARE ON (B)(4) 2018, THAT ON (B)(6) 2018, A PAIRING FAILURE BETWEEN THE TRANSMITTER AND SMART DEVICE AND/OR RECEIVER OCCURRED. NO ADDITIONAL PATIENT OR EVENT INFORMATION IS AVAILABLE. DATA WAS PROVIDED FOR EVALUATION. DATA REVIEW CONFIRMED THE REPORTED EVENT OF PAIRING FAILURE. THE ROOT CAUSE WAS DETERMINED TO BE A FAILED TRANSMITTER ERROR. REPORTED ISSUE OF PAIRING FAILURE IS REPORTABLE BASED ON THE FINDING OF TRANSMITTER FAILURE ERROR.

Additional Manufacturer Narrative

(B)(4).

Description of Event or Problem

THE COMPLAINT DEVICE WAS RETURNED FOR EVALUATION. AN EXTERIOR PHYSICAL VISUAL INSPECTION WAS PERFORMED AND THE DEVICE PASSED. THE TRANSMITTER VOLTAGE WAS TESTED AND FAILED AT 0VDC. THE CLOUD/SHARE DATA WAS AVAILABLE. TRANSMITTER FATAL ERROR WAS FOUND IN SHARE LOG BUT NOT RELATED TO COMPLAINT.