BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POLY C-OMCP-VISUB

    MDR report key: 2021402 · Received February 8, 2011

    Report

    Report Number
    3003768277-2011-00101
    Event Type
    Malfunction
    Date Received
    February 8, 2011
    Report Date
    January 11, 2011
    Manufacturer
    PHILIPS HEALTHCARE
    Product Code
    IZF
    PMA / PMN Number
    K925302
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GM
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). THIS EVENT IS STILL UNDER INVESTIGATION. THE FOLLOW-UP REPORT WILL BE SENT BY (B)(4) 2011.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE SEMI-TRANSPARENT COLLIMATORS ARE STIFF AND STUCK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 POLY C-OMCP-VISUB NA IZF PHILIPS HEALTHCARE 72238

    Patients

    Seq Age Sex Outcome Treatment
    1