BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BV PULSERA 12"

    MDR report key: 1872880 · Received October 1, 2010

    Report

    Report Number
    3003768277-2010-00224
    Event Type
    Malfunction
    Date Received
    October 1, 2010
    Date of Event
    September 2, 2010
    Report Date
    September 2, 2010
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    IZL
    PMA / PMN Number
    K010435
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NL
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    METHOD, RESULTS AND CONCLUSIONS - THE INVESTIGATION IS STILL ONGOING ON THIS EVENT. WHEN THE INVESTIGATION IS COMPLETED A FOLLOW-UP REPORT WILL BE SENT TO THE FDA.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTS THE BRAKE IN THE C-ARM IS NOT FUNCTIONING ON THE X-RAY DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BV PULSERA 12" IZL (MOBILE X-RAY SYSTEM) IZL PHILIPS MEDICAL SYSTEMS 718101 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NA