FDA Adverse Event Other Summary report: N

TRANSCAM

MDR report key: 1760577 · Received June 29, 2010

Report

Report Number
2916556-2010-00002
Event Type
Other
Date Received
June 29, 2010
Report Date
March 15, 2010
Manufacturer
PHILIPS MEDICAL SYSTEMS (CLEVELAND), INC.
Product Code
KPS
PMA / PMN Number
K921296
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

CURRENTLY A THIRD-PARTY VENDOR, (B)(6), SERVICES THIS CAMERA. THE CUSTOMER HAS BEEN INSTRUCTED TO NOT USE THE CAMERA BY (B)(6). THIS SYSTEM WAS END-OF-LIFED (EOL) BY PHILIPS MEDICAL SYSTEMS IN (B)(6) 2009. IF THE SCREWS SUPPORTING THE DETECTOR ARE REMOVED THEY SHOULD BE REINSTALLED PER CURRENT PROCEDURE. A CAPA NOTIFICATION WENT OUT 11/17/1998 TO PHILIPS (B)(4) FIELD SERVICE TO "ALWAYS ADD THREADLOCKING FLUID TO ALL BOLTS: (B)(4). THE USE/INSTALLATION OF HELI-COILS TO REPAIR ANY WEAR CAN BE DONE WITHOUT A PROCEDURE AS IT IS COMMON IN THIS INDUSTRY. (B)(4).

Description of Event or Problem · 1

THE SCREWS HOLDING THE DETECTOR ONTO THE SUPPORT ARM ARE STRIPPED. THERE IS CONCERN THAT THE DETECTOR WILL FALL OFF THE MACHINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRANSCAM TRANSCAM KPS PHILIPS MEDICAL SYSTEMS (CLEVELAND), INC. 5200-2338

Patients

Seq Age Sex Outcome Treatment
1