Dexcom online reporting rant

Diabetes Technology Glucose Monitoring
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Every time I have used the online form to report a sensor failure I have to have a phone conversation with a support person.

I reported one last night and while I was in the middle of a ZOOM session Dexcom called. They also left an email with the following questionnaire.

Thank you for contacting Dexcom Global Technical Support Web Self Service regarding Inaccurate readings on 03/20/2023. Responses may take longer than normal.

We are unable to call you at this time because it is well before our official calling hours. Rest assured that we are working in resolving your concerns at the soonest time possible.

  1. Did the patient experience any symptoms prior to and/or at the time of the event? (example: Nausea, Dizziness) Yes or No
  2. IF YES: Was there any treatment provided to alleviate symptoms prior to and/or at the time of the event? Yes or No
  3. What is the patient’s current condition ( e.g. stable) ?
  4. Did you calibrate the CGM after you noticed the difference?
  5. Did the calibration bring the CGM reading into the expected range?
  6. Prior to the event did any of the following occur that could contribute to a discrepancy between the CGM and BG values?

a. Rubbing/bumping/laying (compression) on transmitter / wearable (G7)

b. Water exposure to the sensor

c. Poor patch adhesion

d. Using multiple BG meters during sensor session

e. Improper CGM sensor / wearable (G7) storage

f. Dialysis

g. Critically ill

h. Expired test strips

i. MRI, CT scan, Diathermy

j. Not Washing hands prior to finger stick

k. Other – Please describe

Once all required information is provided, we will book for a replacement within 24 hours and will be shipped within 3-5 business days. A separate email will be sent for additional information regarding the shipment.

You may visit the Dexcom Help Center to answer your questions regarding your concern:

Is my Dexcom sensor accurate? | Dexcom

If you require immediate assistance, please contact us at 844-607-8398 and provide the case number(s): 230320-007124 or for future reference you can also try other channels by clicking the link below.

I think I will keep that questionnaire and added to the comment section on the online form. Maybe that will be enough, but I doubt it.

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The form for overpatches never works. It always tells me to try later or call tech support. You would think it would be a simple thing, to get the forms to work but no…

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I think we all understand your frustration with the Dexcom system of reporting failures or inaccuracies. Although, unlike Laura_S, I have not had any problem ordering overmatches online, I have given up on trying to talk to Dexcom unless I have to totally scrap a sensor or transmitter.

My latest experiences are two-fold. First, either their adhesives or my skin has undergone a change because lately, I cannot get the tape marks off after wearing a sensor for nine days. Anyone have good ideas for an adhesive remover that will not eat sensitive skin?

Note that I said “nine days” because lately I cannot get a full 10 days out of a sensor with any accuracy. My latest problem had me at day nine get a morning alert at 60, then 55, then 45 all within about 5 minutes. I told my husband that something was wonky because I did not feel low at all. I tested my blood and came up with another surprise – a reading of 212! Just think what would have happened had I tried to treat my fictitious 45 low! I have given up even reporting such happenings, and I just set a schedule now to change my sensor every 8-9 days.

Dexcom still probably makes the best CGM on the market, but their customer service has certainly taken a nose dive.

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I use 70percent ipa, then shower with a wash cloth, but what works. Best is to put down a iv3000 tape before and poking through it with the applicator, then the adhesive nev
on your skin. The iv3000 glue never stays after I remove it

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I’ve never had a follow-up call from Dexcom when I filled out the online form.

My circumstances may be different than yours. I’m located in the United States. Having a background in tech support I’m proactive in providing more detail than they want. I’m fortunate in that I have more time and words than I have other things to do.

I’ve received 5 replacements within 9 months, reporting the failures after a minimum of 12 hours because none of mine failed to give reading; they just never became steady and accurate.

Their response form to me looks like this:

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As soon as I receive that response form I reply to it by inserting a paragraph that has a lot of detail in it about the circumstances and saying that I’ve replaced the sensor. I include a screenshot of the monitoring app I use that clearly shows the deviation and the time of insertion. The combination tells them that I’ve used the product correctly and done basic troubleshooting.

I’ve NEVER had a problem ordering overpatches; they are just sent incredibly slow.

They always preemptively blame slow delivery on the post office, so I started tracking the fullfilment time. (I regularly get mail from the same USPS regional processing center several times a month). On average they were taking 10 days to get their envelopes to the USPS, 4 days to deliver cross-country as first class mail.

The second to last time I ordered them I emailed the tech support address of the failed sensor form asking if the delays were due to a supply shortage, They said they were in the process of creating a “new order processing system”. I replied with a three sentence procedure that told them how to do it with a label printer and pre-stuffed envelopes which would reduce their labor and handling operations by 75%, cut out-the-door time to a day or less.

I’m guessing that they’re not going to do anything comma that there that instead they will wait until the G7 is out, which has over patches prepacked in every carton, and they will use the overpatch delays for the G6 incentivize people to change to the less expensive to manufacture G7

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Well, you just described me to a tee. From now on, I will use those questions in my report.

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I’ve only had one or two phone calls. Usually just email. I have figured out that they are not grilling me over specifics but just gathering data, which I see as A Good Thing. So I know the answers and it only takes a couple of minutes unless I want to explain further, which I usually do and appreciate being able to do it in email.

The comment block is severely limited in number of characters. I have tried to put explanations there, and it’s just too small.

I call that the “falling off a cliff” syndrome. Happens too often.

I even sometimes list my issue as “other” in the form, as I know that will get an email response, into which I can explain fully and even include graphics. Does anyone pay attention, or do they just record that I sent a response and say yeah OK? I don’t know. But my personality is such that I feel better having explained rather than giving inexact answers just to get a free sensor. Heck, I don’t need any more, but even when I say please don’t send one, they do anyway.

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You will always get an automatic email response from Dexcom to an issue reported online. Listing a problem as “other” inline guarantees that you will trigger a worse response with a lengthier questionaire.

“Other” is for something that literally can’t be put into one of the pre-defined categories. Those categories are the result of an analysis of thousands of previously reported problems in their tech support database.

Information you provide after reporting “other” forces a tech to carefully read an email, re-categorize the previous information and start from scratch in re-entering data. (btw “failed after warmup” - in abdomen - seems to be the easiest category to complete.)

I’ve gotten 6 replacement sensors since 4/22, all by inline form. Only for the last one was I asked in the automatic response email to answer more questions. Because I was ready for the automatic responses, I got shipping notices after every issue within 2 hours of my initial report.

It’s possible I have less of a problem because:

  • I have unusually good control.
  • I never expect a sensor to be good, or not need calibration. I use finger sticks until they prove they track in direction and respond to calibration if needed.
  • The screenshots I provide from Xdrip+ clearly show the divergence of the sensors from expected behavior, with fingerstick readings through the period where they
    were unreasonably inaccurate. (Like not rising as expected after a familar meal. )
  • I never reported a failure until at least 12 hours after an insertion/2 meals because I’ve had sensor behave very poorly and then start working.
  • I want to help them close the calls, in the way that I want, with the least amount of work for them.

It helps that my background is engineering (3rd level tech support) and I know how to diagnose, document, illustrate and explain equipment and software failures better than most first level techs that respond to internet requests and phone calls.

I don’t know how Dexcom’s people compare in skill to Tandem’s, but I understand that the kind of systems they use and the kind of supervision they work under must be very similar.

Most of the calls they get are problems and complaints from people who know less than they do, and they are directed to try to minimize future calls that can be avoided without losing customers. The easiest way to do that is to force the callers with the less easy to process issues to answer questions so if they did anything that contributed to the issue, they might realize it. Done by a sympathetic person this is effective. Done by an automatic process it isn’t.

If you can answer questions before they can ask, you short circuit the process and make their work easier. Everyone responds better to customers who make their work easier.

The best time to contact product support is when you have questions about using the product, or practical ideas on how to make it work better. Every call gets put in a database. The next time you contact them, they can retrieve your complete history usually by your name, plus date of birth, phone number or ID/customer number.

I’ve contacted Dexcom support many times, always by internet, once to obtain a full printed user manual, several time for overlays plus 6 times for sensor issues. When I saw how slow and inefficient their overlay fulfillment process was, I let them know that it was hurting their reputation with existing customers and suggested using a temp hire to pre-fill envelopes with address label stickers to cut the steps in half. It may be a coincidence, but two months later they did an unsolicited mass mailing of overlays using address labels.

I’ve spoken to Tandem support several times, only twice with problems. The other times were to alert them to software glitches and some things that don’t match the user manual. It was like being back at work, because when they found that I was interested in improving the product, not complaining about it, they wanted to chat.

I just got my first replacement pump from Tandem, next day air, after a 5 minute call because I thought about what they needed to know before I called them.

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When you use the online form you get an email from Dexcom with a case number. You can reply to that email and include the detains that doesn’t fit into the text box. They get read by the human that is checking the boxes to say you’ve met the requirements to send a replacement.

In one reply I said Dexcom is not in compliance with FDA mandatory device malfunction reporting and cited the specific section of the Code of Federal Regulations. I got a call back from someone who might have actually worked for Dexcom.

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That email questionnaire sure is annoying.

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If by “automatic” you mean “automated”, then no, I don’t. When I submit at night, the email doesn’t come until the next day, though at least once that’s been on a Sunday.

Many of my reports could be put into “readings seem inaccurate”, and I make sure I write down a pair of readings that fit their criteria in case I don’t want to take the time to explain. But there are many variations of inaccurate readings, and they need to know about (and should be asking about) those variations. Just being off 20% is a minor matter; if it’s consistent then calibration may deal with it. Ripples, spikes, sudden fall followed by sensor error – these are very different issues.

I recently had one with three hours of what looked like a scatter plot, random numbers. (Though ironically none that caused an alert, which is why I didn’t kill it sooner.)

Drops 50 points in ten minutes, then back to normal in ten minutes, with no apparent cause, in particular not a compression issue.

Recently had a case of 114, 118, 118, 103, 84, 59, 80, 84, 114, 131, 149, 161 etc. Unfortunately when I got the truck-siren alarm, I acted to correct before looking at the graph, resulting in >300 an hour later. Definitely no external cause. But a sequence of five bad readings is a whole lot different from long term bad readings. But if happened when I was at a concert, it would have been a disaster – phone ringing is bad bad bad, but the urgent low siren, when false, is beyond the pale.

I certainly hope they continue analyzing. However, the fact that they make it easy to get a replacement sensor by entering a pair of numbers, which they have no way to validate, almost certainly means that many reports are made the easy way, and thus that variations don’t get properly categorized.

Reading carefully is good. Re-categorizing to one of the existing categories, when the problem doesn’t fit the category, is hiding information. When I’ve provided additional information, I have never received feedback, just “shipped”.

Careful? When I write “please don’t send a sensor, I have more than enough”, they invariably ignore me.

I’ve gotten about 35 replacements since the start of 2021. (On me, sensors usually last at least 7 days, but often fail before 10 days.) If the form had space for a full explanation, including the ability to upload graphs, I’d utilize those. The lack of space on the form discourages complete reporting.

My first concern is that I want them to understand the problems I had, even if those problems don’t fit their predetermined categories. Reducing their work is good as long as it is subsidiary to the first concern. Same with closing the call – that’s good if the problem has been fully recognized and recorded, but not just for the sake of closing the call.

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I don’t think l’ve ever had one of my posts read so carefully and nitpicked so extensively before. I don’t know whether to be insulted, flattered or to give you an award.

What your response tells me is that:
You don’t understand that the mechanism of subdermal scarring doesn’t depend on who you are , just that you stuck something foreign under your skin, and your body is trying to protect you with a “scab” around it.
You don’t understand that ranting or commiserating in a forum won’t get you any replacement Dexcom sensors.
You don’t know how to make the system work for you and believe it should change to fit you. It won’t. It can’t. It’s optimized to be cost efficient, not customer pleasing but complaint cost controlling.

I wrote automatic and I meant it. Something is automatic whether done by a person or a machine. Whatever you fill out in the form is read by something which follows a predefined procedure. The outcomes are predictable - boilerplate messages with SSR#s inserted. Knee-jerk responses.

Dexcom probably has CSAs tapping confirmation boxes on screens to keep the FDA happy, and more customer service agents are likely to be available at certain times than others. Night shifts, weekends and holidays have generally lower staffing levels, less capable CSAs. The less capable the CSA, the more they need to wait for help from supervisors. Call early in the week on a business day and you increase the chance of a sensor leaving the building you that same day.

“Sensor failed after warmup”, location: abdomen, is the message this system find easiest to process. It produces the simplest message, one which could be sent automatically without human intervention.

The message is:

" Thank you for submitting your self-service request to the Dexcom Technical Support team. Your Dexcom Technical Support Service Request # is:000000-000000. A follow-up from a Technical Support Agent should arrive within 48 hours. In the meantime, please visit the quick answers section of our website at Dexcom G6 CGM Questions & Answers | Dexcom where most common questions have already been answered." etc

If you respond to this, today a CSA must handle it. CSAs get rated on the number of calls they close. All they need to close a failed-after-warmup call is enough detail to quickly convince them that it’s a real problem and matches the category.

So at the top of the reply, I respond with information that confirms my issue in a way that can’t be debated. It takes me 5 minutes to write something like this, working from my Xdrip screens.

" I inserted this sensor shortly after an MRI, on 12/14 at 1415. It was initially very high and erratic when my BG was stable and in the 130s. After a calibration 6 hours later it started to more closely match my BG meter then started oscillating +/-20 mg/dL. At dinner on 1215 at 1830 it was close to my BG meter at 110 mg/dL.

As I was watching TV after dinner, it indicated a less-than-expected rise to 150mg/dL, a slight drop by 2115 to 130 mg/dL, then a rise to 170 at 2145 followed by a sharp drop to 58 mg/dL . My BG meter read 120-130 during this drop and afterward.

This sensor being clearly unreliable, I replaced it at 2215. The new sensor was stable during its first 6 hours. I calibrated it at 0745 and used the calibration value for my morning bolus.

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"

I always show the failure and when possible the sequence of what I described. I always get a reply like this within minutes:

" Hello xxxxxx

Thank you for completing the answers on our Web Self-Service Form regarding Inaccurate Readings. We have documented your concern and we will be sending the replacement/s for the following: 1x Sensor

You will receive a confirmation email with tracking information once the replacement has been shipped." etc

The longest I’ve ever waited for a shipping notice with a tracking number was overnight .

My only objective is to get a replacement sensor with the least amount of effort.

Technical CSA (first level support techicians) do not get paid to understand issues or to prevent them from recurring, just to recognize, categorize and validate them.

If I had a problem that could not be fit into one of the named online categories, IF my need wasn’t a replacement sensor AND IF I could benefit from information from a support tech OR I believed that I’d found something important and dangerous to other, then I’d phone them.

But in any other case, I’d do whatever I needed to do to minimize my inconvenience. When that requires checking a few boxes boxes and writing a carefully-phrased paragraph to make it easier for a CSA to decide to press a button, I’ll do it.

That’s a win-win solution that works.

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I agree you need to play the system game. I never try to get more than I deserve, but I’m also not going to accept that a failure of a sensor is my fault if it’s not.
I exclusively use my arms for sensors and I never get scars or even inflamed sites.
My infusion sites are the opposite. I get inflamed and scarred and all that.
Bodies react differently to foreign objects.
Most diabetics who use insulin have abnormal blood counts (cbc). That’s because we have high Eosinophil counts. And we get that from constantly poking ourselves. Our bodies respond sending Eosinophils to respond to what it thinks is a parasite.
However it’s just a cannula or a sensor wire.

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This seems to be our main point of disagreement. Getting a replacement sensor with little effort is simple. My top priority is to try to get the real problem passed on to the developers. Maybe I’ll succeed, quite likely I won’t. But I will try, and fitting a square peg into a round hole does not accomplish that.

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I am with you on this

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I like it simple and easy. I flll out the form and then I get an e-mail saying they are shipping my replacement.

The only time I have any issues with the overpatches are when I order them sooner than when I’m “allowed”. The problem with that is remembering when you are “allowed”. And they come on a very slow boat. Since I restart mine it’s usually not an issue, but I think I have more sensors than overpatches.

I did call tech purposely when I started a new transmitter and sensor at the same time and I had the sensor have wildly bad numbers and wouldn’t calibrate. It kept reverting to the old numbers. I wondered if the transmitter had a problem so I wanted to call. I was told no, it’s the sensor. Start another one and the same thing so I called again and was told the same thing. We’ll replace the sensor. Third one, same thing. Okay, well this time I’m starting a new transmitter with a new sensor. That worked, so then I called and told them I needed a new transmitter and sensor, that it happened again, replaced them both and now I’m not having an issue. I was asked so you replaced the transmitter, good, because some people are having the same problem and you have to replace the transmitter. We’ll send replacements. “Eye Roll”!

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