FDA Adverse Event Malfunction Summary report: N

INTEGRIS C2000

MDR report key: 1872929 · Received October 5, 2010

Report

Report Number
3003768277-2010-00227
Event Type
Malfunction
Date Received
October 5, 2010
Date of Event
August 12, 2010
Report Date
August 12, 2010
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
IZI
PMA / PMN Number
K902542
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(METHOD, RESULTS, CONCLUSIONS) - THE INVESTIGATION IS STILL ONGOING ON THIS EVENT. WHEN THE INVESTIGATION IS COMPLETED, A F/U REPORT WILL BE SENT TO THE FDA.

Description of Event or Problem · 1

THIS X-RAY SYSTEM WAS NOT WORKING DURING AN EXAM WHILE PT IS ON TABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTEGRIS C2000 IZI (SYSTEM, X-RAY, ANGIOGRAPHIC) IZI PHILIPS MEDICAL SYSTEMS 72230 NA

Patients

Seq Age Sex Outcome Treatment
1