FDA Adverse Event Malfunction Summary report: N

INTEGRIS HM3000

MDR report key: 1942703 · Received November 29, 2010

Report

Report Number
3003768277-2010-00340
Event Type
Malfunction
Date Received
November 29, 2010
Date of Event
November 5, 2010
Report Date
November 5, 2010
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
IZF
PMA / PMN Number
K925302
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(CONCLUSIONS) - THE INVESTIGATION FOUND THE REPLACEMENT OF COMPONENT, FIGARO II GENERATOR CONTROL, CORRECTED THE PROBLEM. BASED ON TRENDING ANALYSIS THERE IS NO EXCEPTIONAL REPLACEMENT RATE OF THIS PART. THERE IS NO REQUIRED MANDATORY FIELD ACTION.

Description of Event or Problem · 1

THIS X-RAY SYSTEM WENT DOWN WITH PT ON TABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTEGRIS HM3000 IZF (SYSTEM, X-RAY, TOMOGRAPHIC) IZF PHILIPS MEDICAL SYSTEMS 72239 NA

Patients

Seq Age Sex Outcome Treatment
1