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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEXCOM, INC. DEXCOM FOLLOW APP; CONTINUOUS GLUCOSE MONITOR

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DEXCOM, INC. DEXCOM FOLLOW APP; CONTINUOUS GLUCOSE MONITOR Back to Search Results
Catalog Number SW14255
Medical Device Problem Code Defective Alarm (1014)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/06/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that an alert/notification settings issue occurred.No product or data was provided for evaluation.The allegation and a probable cause could not be determined.No injury or medical intervention was reported.
 
Additional Manufacturer Narrative
(b)(4).
 
Additional Manufacturer Narrative
(b)(4).3004753838-2025-243106 was reported in error.Please disregard initial reporting of this event as this event has now been deemed not reportable.
 
Event or Problem Description
Subsequent to the initial mdr, it was determined that a report was submitted in error.Upon further review, it was determined that the patient allegation does not meet the criteria of a reportable event.
 
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Brand Name
DEXCOM FOLLOW APP
Common Device Name
CONTINUOUS GLUCOSE MONITOR
Manufacturer (Section D)
DEXCOM, INC.
6340 sequence dr.
san diego CA 92121
Manufacturer Contact
ashley spoto
6340 sequence dr.
san diego, CA 92121
8582000200
MDR Report Key22943032
Report Number3004753838-2025-243106
Device Sequence Number21298359
Product Code QBJ
UDI-Device Identifier00386270004475
UDI-Public(01)00386270004475
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
DEN140038
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 10/01/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Lay User/Patient
Device Catalogue NumberSW14255
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 08/06/2025
Supplement Date Received by Manufacturer09/03/2025
Initial Report FDA Received Date09/02/2025
Supplement Report FDA Received Date10/01/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient Age28 YR
Patient SexMale
Patient Weight82 KG
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