FDA Adverse Event Malfunction Summary report: N

ALLURA XPER FD10 C

MDR report key: 2002553 · Received January 28, 2011

Report

Report Number
3003768277-2011-00059
Event Type
Malfunction
Date Received
January 28, 2011
Report Date
January 3, 2011
Manufacturer
PHILIPS HEALTHCARE
Product Code
IZI
PMA / PMN Number
K031333
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE INVESTIGATION IS STILL ONGOING ON THIS EVENT. WHEN INVESTIGATION IS COMPLETED, A FOLLOW-UP REPORT WILL BE SENT TO THE FDA BY (B)(4) 2011.

Description of Event or Problem · 1

CUSTOMER REPORTED THAT THE SCREEN THAT CONTROLS THE PROGRAMS OF RADIOGRAPHY REMAINS BLACK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ALLURA XPER FD10 C IZI, MBQ IZI PHILIPS HEALTHCARE 722001

Patients

Seq Age Sex Outcome Treatment
1