BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    2800

    MDR report key: 2100728 · Received May 12, 2011

    Report

    Report Number
    1720753-2011-07240
    Event Type
    Malfunction
    Date Received
    May 12, 2011
    Date of Event
    April 29, 2011
    Report Date
    May 12, 2011
    Manufacturer
    GE OEC MEDICAL SYSTEMS (SLC)
    Product Code
    JAA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE CUSTOMER CANCELLED THE SERVICE CALL. THE REPORTED PROBLEM WAS RESOLVED BY THE CUSTOMER NO ADDITIONAL SERVICE INFORMATION WAS PROVIDED.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE MONITORS ON THE SYSTEM WERE BLACK AND THE FOOT PEDAL WOULD STICK. NO PT INJURY WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 2800 FLUOROSCOPIC X-RAY JAA GE OEC MEDICAL SYSTEMS (SLC) 2800

    Patients

    Seq Age Sex Outcome Treatment
    1