FDA Adverse Event
Malfunction
Summary report: N
ALLURA XPER FD10
MDR report key: 1942721
·
Received November 29, 2010
Report
- Report Number
- 3003768277-2010-00338
- Event Type
- Malfunction
- Date Received
- November 29, 2010
- Date of Event
- November 1, 2010
- Report Date
- November 1, 2010
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- IZI
- PMA / PMN Number
- K031333
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- 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 FOLLOW-UP REPORT WILL BE SENT TO THE FDA. (B)(4)
Description of Event or Problem · 1
THIS X-RAY SYSTEM STOPPED FLUORO ON THE LATERAL GENERATOR, THE XPER MODULE WENT DARK, AND THE FLUORO IMAGE WOULD NOT UPDATE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | ALLURA XPER FD10 | IZI (SYSTEM, X-RAY ANGIOGRAPHIC) | IZI | PHILIPS MEDICAL SYSTEMS | 722003 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |