Brand Name | EVERSENSE SENSOR |
Type of Device | EVERSENSE CONTINUOUS GLUCOSE MONITOR SYSTEM |
Manufacturer (Section D) |
SENSEONICS, INCORPORATED |
20451 seneca meadows parkway |
germantown MD 20876 7005 |
|
Manufacturer (Section G) |
SENSEONICS, INCORPORATED |
20451 seneca meadows parkway |
|
germantown MD 20876 7005 |
|
Manufacturer Contact |
vallikannu
somasundaram
|
20451 seneca meadows parkway |
germantown, MD 20876-7005
|
|
MDR Report Key | 18568468 |
MDR Text Key | 333535442 |
Report Number | 3009862700-2024-00207 |
Device Sequence Number | 1 |
Product Code |
QCD
|
Combination Product (y/n) | Y |
Reporter Country Code | GM |
PMA/PMN Number | P160048 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Consumer |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
01/24/2024 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Lay User/Patient
|
Device Expiration Date | 02/05/2022 |
Device Model Number | 101967-750 |
Device Catalogue Number | FG-4400-50-302 |
Device Lot Number | WP08294 |
Was Device Available for Evaluation? |
No
|
Initial Date Manufacturer Received |
06/08/2021
|
Initial Date FDA Received | 01/24/2024 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 03/08/2021 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Other;
|