BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ALLURA XPER FD10

    MDR report key: 2020570 · Received February 10, 2011

    Report

    Report Number
    3003768277-2011-00139
    Event Type
    Malfunction
    Date Received
    February 10, 2011
    Report Date
    January 13, 2011
    Manufacturer
    PHILIPS HEALTHCARE
    Product Code
    IZI
    PMA / PMN Number
    K031333
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). THE FIELD SERVICE ENGINEER REPORTED THE CAUSE OF THIS PROBLEM WAS THE CONVERTER UNIT IN THE HIGH VOLTAGE GENERATOR. AFTER REPLACEMENT THE PROBLEM WAS SOLVED.

    Description of Event or Problem · 1

    THE CUSTOMER STATES THAT IT IS NOT POSSIBLE TO GENERATE X-RAY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ALLURA XPER FD10 IZI, MBQ IZI PHILIPS HEALTHCARE 722003

    Patients

    Seq Age Sex Outcome Treatment
    1