BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    STANDARD VIDEO CART KIT

    MDR report key: 1767587 · Received July 19, 2010

    Report

    Report Number
    2936485-2010-00560
    Event Type
    Malfunction
    Date Received
    July 19, 2010
    Date of Event
    June 29, 2010
    Report Date
    June 29, 2010
    Manufacturer
    STRYKER ENDOSCOPY SAN JOSE
    Product Code
    FXM
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    ADDITIONAL INFORMATION WILL BE PROVIDED ONCE THE INVESTIGATION IS COMPLETED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE ACCOUNT REVIEWED THE POWER CORDS ON THEIR CARTS AND NOTICED THAT THE CABLES WERE "SPLITTING". IT WAS FURTHER REPORTED THAT THIS ISSUE MAY BE RELATED TO AGE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STANDARD VIDEO CART KIT CART FXM STRYKER ENDOSCOPY SAN JOSE UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK