FDA Adverse Event
Malfunction
Summary report: N
BLACKDIAMOND HDMI CABLE
MDR report key: 19981304
·
Received August 14, 2024
Report
- Report Number
- 3008776287-2024-00014
- Event Type
- Malfunction
- Date Received
- August 14, 2024
- Date of Event
- April 5, 2024
- Report Date
- August 14, 2024
- Manufacturer
- BLACK DIAMOND VIDEO, INC.
- Product Code
- KQM
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
THE REPORT DID NOT IDENTIFY THE NAME OR LOCATION OF THE USER FACILITY OF THE DEVICE IN QUESTION THEREFORE, ADDITIONAL INFORMATION COULD NOT BE OBTAINED. TO DATE WE HAVE NOT BEEN INFORMED OF THIS EVENT DIRECTLY FROM THE USER FACILITY. A FOLLOW-UP REPORT WILL BE SUBMITTED SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE. NO ADDITIONAL ISSUES HAVE BEEN REPORTED.
Description of Event or Problem · 0
THE USER FACILITY REPORTED VIA MEDWATCH REPORT MW5156331 THAT SMOKE WAS EMITTING FROM THEIR BLACK DIAMOND HDMI CABLE. NO REPORT OF INJURY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 234798 | BLACKDIAMOND HDMI CABLE | CAMERA, SURGICAL AND ACCESSORIES | KQM | BLACK DIAMOND VIDEO, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |