BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    GREENLIGHT HPS LASER SYSTEM

    MDR report key: 1944028 · Received December 29, 2010

    Report

    Report Number
    2937094-2010-01483
    Event Type
    Malfunction
    Date Received
    December 29, 2010
    Date of Event
    December 2, 2010
    Report Date
    December 2, 2010
    Manufacturer
    AMERICAN MEDICAL SYSTEMS, INNOVATION CENTER- SILICON VALLEY
    Product Code
    GEX
    PMA / PMN Number
    K062719
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NM, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED BY THE CUSTOMER ON (B)(4) 2010 THAT DURING THE PROCEDURE THE SYSTEM SHUTDOWN, BEFORE THE SYSTEM SHUTDOWN IT SHOWED A MESSAGE, "SCHEDULE PM". THE CUSTOMER CHECKED ALL OF THE POWER AND EMERGENCY POWER, TURNED THE SYSTEM ON BUT STILL THERE WAS NO POWER. AN AMS FIELD ENGINEER ANALYZED THE SYSTEM AND PER THE SERVICE REPORT, THE SYSTEM WOULD NOT POWER ON.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GREENLIGHT HPS LASER SYSTEM LASER SURGICAL INSTRUMENT GEX AMERICAN MEDICAL SYSTEMS, INNOVATION CENTER- SILICON VALLEY 0010-0070 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 Other