FDA Adverse Event
Malfunction
Summary report: N
PENTAX
MDR report key: 12222461
·
Received July 24, 2021
Report
- Report Number
- 9610877-2021-10352
- Event Type
- Malfunction
- Date Received
- July 24, 2021
- Date of Event
- March 26, 2021
- Report Date
- July 24, 2021
- Manufacturer
- HOYA CORPORATION PENTAX TOKYO OFFICE
- Product Code
- PEA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CH
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
EVALUATION SUMMARY: IT WAS CAUSED DUE TO AN OVERCURRENT FLOWING WHEN THE PROCESSOR WAS TURNED ON. MODEL EPK-I7010-US IS AVAILABLE IN THE USA WITH A 510K NUMBER K182004. THIS REPORT IS BEING FILED AS PART OF THE PENTAX BACKLOG MANAGEMENT PLAN.
Description of Event or Problem · 1
WHEN THE PROCESSOR POWERS ON, THE FUSE BLOWN. AFTER REPLACING NEW FUSE, THE PROCESSOR CAN WORK WELL. THIS EVENT OCCURRED AT THE TIME OF BEFORE USE. THERE WAS NO REPORT OF PATIENT HARM.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1119427 | PENTAX | VIDEO PROCESSOR | PEA | HOYA CORPORATION PENTAX TOKYO OFFICE | EPK-I7000 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |