BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ALLURA XPER FD20

    MDR report key: 2002535 · Received January 28, 2011

    Report

    Report Number
    3003768277-2011-00050
    Event Type
    Malfunction
    Date Received
    January 28, 2011
    Report Date
    December 30, 2010
    Manufacturer
    PHILIPS HEALTHCARE
    Product Code
    IZI
    PMA / PMN Number
    K031333
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). THIS EVENT IS STILL UNDER INVESTIGATION.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTS THAT THE MACHINE SHUT OFF IN THE MIDDLE OF A CASE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ALLURA XPER FD20 IZI, MBQ IZI PHILIPS HEALTHCARE 722006

    Patients

    Seq Age Sex Outcome Treatment
    1