BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    INTEGRIS H5000F/ALLURA 9F

    MDR report key: 2043234 · Received February 24, 2011

    Report

    Report Number
    3003768277-2011-00210
    Event Type
    Malfunction
    Date Received
    February 24, 2011
    Report Date
    January 28, 2011
    Manufacturer
    PHILIPS HEALTHCARE
    Product Code
    IZI
    PMA / PMN Number
    K971365
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). THE INVESTIGATION IS STILL ONGOING ON THIS EVENT. WHEN THE INVESTIGATION IS COMPLETED, A FOLLOW-UP REPORT WILL BE SENT TO THE FDA ON 04/26/2011.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE FLUORO IS STICKING CAUSING SYSTEM TO GENERATE X-RAY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INTEGRIS H5000F/ALLURA 9F IZI PHILIPS HEALTHCARE 722017

    Patients

    Seq Age Sex Outcome Treatment
    1