BEUDAMED
    FDA Adverse Event Other Summary report: N

    BRILLIANCE BIG BORE

    MDR report key: 1403317 · Received June 10, 2009

    Report

    Report Number
    1525965-2009-00030
    Event Type
    Other
    Date Received
    June 10, 2009
    Date of Event
    April 28, 2009
    Report Date
    June 4, 2009
    Manufacturer
    PHILIPS HEALTCARE
    Product Code
    JAK
    PMA / PMN Number
    K033357
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4).

    Description of Event or Problem · 1

    A PATIENT'S GOWN SNAGGED ON A CT GANTRY AND WAS PULLED IN AN UPWARD MOTION. NO DEATH OR INJURY HAS OCCURRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BRILLIANCE BIG BORE JAK - CT SCANNER JAK PHILIPS HEALTCARE 728243

    Patients

    Seq Age Sex Outcome Treatment
    1