BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    9600

    MDR report key: 2101982 · Received May 18, 2011

    Report

    Report Number
    1720753-2011-07398
    Event Type
    Malfunction
    Date Received
    May 18, 2011
    Date of Event
    May 4, 2011
    Report Date
    May 18, 2011
    Manufacturer
    GE OEC MEDICAL SYSTEMS (SLC)
    Product Code
    JAA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    A GE SERVICE REP PERFORMED AN ONSITE INVESTIGATION. THE SERVICE REP RESEATED THE POWER CONNECTOR ON THE MONITOR AND CHECKED THE 24V POWER SUPPLY. THE MONITOR WILL BE REPLACED BY THE CUSTOMER. THE SYSTEM OPERATES AS INTENDED.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE SYSTEM WOULD INTERMITTENTLY LOSE AN IMAGE DURING FLUOROSCOPIC X-RAY. NO PT INJURY WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 9600 FLUOROSCOPIC X-RAY JAA GE OEC MEDICAL SYSTEMS (SLC) 9600

    Patients

    Seq Age Sex Outcome Treatment
    1