FDA Adverse Event Other Summary report: N

BRILLIANCE EBW

MDR report key: 2094112 · Received May 9, 2011

Report

Report Number
1525965-2011-00024
Event Type
Other
Date Received
May 9, 2011
Report Date
April 14, 2011
Manufacturer
PHILIPS MEDICAL SYSTEMS (CLEVELAND), INC.
Product Code
JAK
PMA / PMN Number
K012009
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE INVESTIGATION IS ON-GOING AND A FOLLOW-UP MDR WILL BE SENT WHEN THE INVESTIGATION IS COMPLETED. (B)(4). THIS REPORT WAS MAILED ON (B)(4) 2011.

Description of Event or Problem · 1

PHILIPS RECEIVED A CUSTOMER COMPLAINT THAT ALLEGED WHEN A CURVED LINE IS DRAWN THE IMAGE FLIPS. THERE ARE NO REPORTED INJURIES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BRILLIANCE EBW JAK PHILIPS MEDICAL SYSTEMS (CLEVELAND), INC. 728260

Patients

Seq Age Sex Outcome Treatment
1