FDA Adverse Event Malfunction Summary report: N

INTRASIGHT

MDR report key: 13904596 · Received March 25, 2022

Report

Report Number
3008363989-2022-00022
Event Type
Malfunction
Date Received
March 25, 2022
Date of Event
March 4, 2022
Report Date
July 26, 2022
Manufacturer
PHILIPS VOLCANO
Product Code
IYO
UDI-DI
00845225012878
PMA / PMN Number
K190078
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS CASE WAS REVIEWED AND INVESTIGATED ACCORDING TO THE MANUFACTURE¿S POLICY. NO PATIENT INVOLVEMENT. LOT# AND EXPIRATION DATE ARE NOT APPLICABLE. NOT APPLICABLE; NO PATIENT INVOLVEMENT. AT THE CUSTOMER SITE, A FIELD SERVICE ENGINEER REPLACED THE CRACKED INTRASIGHT SYSTEM'S TOUCHSCREEN MONITOR AND VERIFIED THAT IT IS WORKING GOOD TO OEM SPECIFICATIONS.

Additional Manufacturer Narrative · 0

BASED ON THE RETURNED PRODUCT EVALUATION, THIS IS NO LONGER REPORTABLE FOR A PRODUCT PROBLEM/MALFUNCTION. BLOCKS D9/G3: THE INTRASIGHT TOUCHSCREEN MONITOR WAS RETURNED FOR EVALUATION. BLOCK H3: VISUAL INSPECTION FOUND A CRACKED SCREEN WITH MISSING MATERIAL, BUT NO SHARP EDGES WERE NOTED AS DETERMINED BY A GLOVE TEST. BLOCK H6: MEDICAL DEVICE PROBLEM CODE CORRECTED FROM 4013 (SHARP EDGES) TO 1135 (CRACK) BASED ON THE RETURNED PRODUCT EVALUATION. THE COMPLAINT CODES LISTED IN THE INITIAL MDR REMAIN ACCEPTABLE (10- TYPE OF INVESTIGATION, 3252- INVESTIGATION FINDINGS, AND 61- INVESTIGATION CONCLUSION). THE PROBABLE CAUSE IS LIKELY DAMAGED FROM USE. THE DEVICE INTEGRITY CAN BE AFFECTED BY EXTERNAL FACTORS SUCH AS DEVICE MANIPULATION, ITS IMPACT, AND APPLIED PRESSURE ASSOCIATED WITH USE AND HANDLING. SUBMISSION OF THIS REPORT DOES NOT, IN ITSELF, REPRESENT A CONCLUSION BY THE MANUFACTURER AND/OR AUTHORIZED REPRESENTATIVE OR THE NATIONAL COMPETENT AUTHORITY THAT THE CONTENT OF THIS REPORT IS COMPLETE OR ACCURATE, THAT THE MEDICAL DEVICE(S) LISTED FAILED IN ANY MANNER AND/OR THAT THE MEDICAL DEVICE(S) CAUSED OR CONTRIBUTED TO AN ALLEGED DEATH OR DETERIORATION IN THE STATE OF THE HEALTH OF ANY PERSON.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE MANUFACTURER'S SYSTEM'S TOUCHSCREEN MONITOR WAS CRACKED IN TWO CORNERS WITH SHARP EDGES OBSERVED. THERE WAS NO PATIENT PRESENT AND NO USER INJURY REPORTED. THIS PRODUCT PROBLEM IS BEING REPORTED IN AN ABUNDANCE OF CAUTION BECAUSE THE TOUCHSCREEN MONITOR WAS CRACKED IN TWO CORNERS WITH SHARP EDGES THAT CAN RESULT IN A POTENTIAL FOR HARM.

Description of Event or Problem · 0

THIS PRODUCT PROBLEM IS NO LONGER REPORTABLE BECAUSE NO SHARP EDGES WERE OBSERVED DURING THE RETURNED PRODUCT EVALUATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1053662 INTRASIGHT SYSTEM, IMAGING, PULSED ECHO, ULTRASONIC IYO PHILIPS VOLCANO 797403 00845225012878

Patients

Seq Age Sex Outcome Treatment
1 Unknown