FDA Adverse Event Malfunction Summary report: N

HUT EXT DR FINAL ASSY-STANDARD

MDR report key: 1360481 · Received March 25, 2009

Report

Report Number
1518293-2009-00078
Event Type
Malfunction
Date Received
March 25, 2009
Date of Event
March 6, 2009
Report Date
March 6, 2009
Manufacturer
LIEBEL-FLARSHEIM CO.
Product Code
KQS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

FIELD SERVICE ENGINEER TROUBLESHOT GENERATOR COMMUNICATION ERROR PER GENERATOR SERVICE MANUAL. FSE REPLACED INCOMING LINE 50V FUSES IN THE GENERATOR AND RESEATED GENERATOR INTERFACE CABLE J1 ON THE INTERFACE PCB. THE SYSTEM WAS CHECKED AND VERIFIED FOR PROPER OPERATION PER THE GENERATOR SERVICE MANUAL 7102273. RETURNED TO FULL SERVICE BY THE CUSTOMER.

Description of Event or Problem · 1

ON 03/11: CUSTOMER REPORTS FLUORO FAILURE DURING A PROCEDURE. NO ADDITIONAL INFORMATION MADE AVAILABLE BY THE CUSTOMER. NO REPORTED INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HUT EXT DR FINAL ASSY-STANDARD UROLOGY SUITE KQS LIEBEL-FLARSHEIM CO. HUT EXT DR NA

Patients

Seq Age Sex Outcome Treatment
1 UNK