FDA Adverse Event Other Summary report: N

1200SX, 600SE, PQ/IQ CT SCANNERS

MDR report key: 1800901 · Received August 9, 2010

Report

Report Number
MW5017053
Event Type
Other
Date Received
August 9, 2010
Report Date
August 9, 2010
Manufacturer
PHILIPS MEDICAL BOTHELL WA
Product Code
JAK
Report Source
Voluntary report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE PQ/IQ CT SCANNERS PREDICATE DEVICE IS THE 1200SX CT SCANNER. THE 1200SX DOES NOT SHOW A PREMARKET NOTIFICATION -510K- NUMBER. PHILLIPS HAS NOT PRODUCED A 510K NUMBER. THEREFORE, THE 1200SX, 600SE, PQ/IQ CT SCANNERS IS/OR MAY BE ADULTERATED BY THE DESCRIPTION IN 21 CFR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 1200SX, 600SE, PQ/IQ CT SCANNERS 1200SX, 600SE, PQ/IQ CT SCANNERS JAK PHILIPS MEDICAL BOTHELL WA 1200SX, 600SE

Patients

Seq Age Sex Outcome Treatment
1 Other 1200SX, 600SE, PQ/IQ CT SCANNERS