FDA Adverse Event
Malfunction
Summary report: N
MULTI DIAGNOST 4
MDR report key: 2062994
·
Received March 21, 2011
Report
- Report Number
- 3003768277-2011-00296
- Event Type
- Malfunction
- Date Received
- March 21, 2011
- Report Date
- February 24, 2011
- Manufacturer
- PHILIPS HEALTHCARE
- Product Code
- JAA
- PMA / PMN Number
- K961374
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SW
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). WHEN INVESTIGATION IS COMPLETED, A FOLLOW-UP REPORT WILL BE SENT TO THE FDA.
Description of Event or Problem · 1
THE CUSTOMER STATES THAT: "THE BELT TO THE C ARCH THAT RUNS THE TUBE ANGLE IS DETACHED".
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | MULTI DIAGNOST 4 | JAA | PHILIPS HEALTHCARE | 708031 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |