BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DISCOVERY XR650

    MDR report key: 2097095 · Received May 2, 2011

    Report

    Report Number
    2126677-2011-00097
    Event Type
    Malfunction
    Date Received
    May 2, 2011
    Date of Event
    October 10, 2010
    Report Date
    May 2, 2011
    Manufacturer
    GE MEDICAL SYSTEMS, LLC
    Product Code
    IZF
    PMA / PMN Number
    K051967
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SA
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    INITIAL REPORTER'S OCCUPATION IS NOT KNOWN AT THIS TIME. THIS MALFUNCTION WAS DETERMINED TO BE REPORTABLE AS THIS SAME MALFUNCTION HAS PREVIOUSLY CONTRIBUTED TO A SERIOUS INJURY WITHIN THE LAST TWO YEARS. REFERENCE MDR 2126677-2010-00010.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE LEFT PT BARRIER ROTATIONAL HANDLE LOCK WAS BROKEN. NO INJURY WAS REPORTED. GE HEALTHCARE'S INVESTIGATION INTO THE REPORTED OCCURRENCE IS STILL ONGOING. A FOLLOW-UP REPORT WILL BE ISSUED WHEN THE INVESTIGATION HAS BEEN COMPLETED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DISCOVERY XR650 X-RAY SYSTEM IZF GE MEDICAL SYSTEMS, LLC

    Patients

    Seq Age Sex Outcome Treatment
    1