inforMED
MalfunctionPFQ

DEXCOM G5 MOBILE CONTINUOUS GLUCOSE MONITORING SYSTEM

Received Aug 1, 2018 · Event occurred May 11, 2018

Report 3004753838-2018-078472 · MDR key 7741637

Device

Generic name

Pqf

Manufacturer

Dexcom, Inc.

Model number

9438-06

Catalog number

STT-GF-001

Lot number

6004138

Product problems

  • Connection Problem
  • Connection Problem

Patient

4 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, RECEIVER, AND SMART DEVICE OCCURRED. NO ADDITIONAL PATIENT OR EVENT INFORMATION IS AVAILABLE. NO PRODUCT WAS PROVIDED FOR EVALUATION. DATA WAS PROVIDED FOR EVALUATION. DATA REVIEW DID NOT CONFIRM THE REPORTED EVENT OF PAIRING FAILURE. A ROOT CAUSE COULD NOT BE DETERMINED VIA DATA. THE 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

PRODUCT WAS RETURNED. AN EXTERIOR PHYSICAL VISUAL INSPECTION WAS PERFORMED AND PASSED. A VOLTAGE MEASUREMENT WAS TAKEN AND FAILED AT 0 VDC. A SHARE LOG REVIEW WAS PERFORMED AND A FAILURE TO PAIR WAS FOUND. A FATAL ERROR WAS OBSERVED FOR A DIFFERENT TX ID (B)(4) AND IS NOT RELATED TO THIS INVESTIGATION. THE ALLEGED TRANSMITTER HAS ALREADY BEEN SCRAPPED.