BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    9900

    MDR report key: 2100384 · Received May 13, 2011

    Report

    Report Number
    1720753-2011-07322
    Event Type
    Malfunction
    Date Received
    May 13, 2011
    Date of Event
    May 2, 2011
    Report Date
    May 13, 2011
    Manufacturer
    GE OEC MEDICAL SYSTEMS (SLC)
    Product Code
    JAA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE GE SERVICE REPRESENTATIVE CONDUCTED AN ONSITE INVESTIGATION. THE CANDLE STICKS WERE CLEANED AND REGREASED. THE SYSTEM WAS TESTED AND OPERATES AS INTENDED.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE SYSTEM MADE A LOUD NOISE THEN LOST ALL POWER. THIS EVENT OCCURRED DURING A PROCEDURE. NO PATIENT INJURY WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 9900 FLUOROSCOPIC X-RAY JAA GE OEC MEDICAL SYSTEMS (SLC) 9900

    Patients

    Seq Age Sex Outcome Treatment
    1