BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    9900

    MDR report key: 2153517 · Received June 21, 2011

    Report

    Report Number
    1720753-2011-08370
    Event Type
    Malfunction
    Date Received
    June 21, 2011
    Date of Event
    June 14, 2011
    Report Date
    June 21, 2011
    Manufacturer
    GE OEC MEDICAL SYSTEMS (SLC)
    Product Code
    JAA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    A GE SERVICE REPRESENTATIVE PERFORMED AN ONSITE INVESTIGATION AND REPLACED THE INTERCONNECT CABLE AND THE RECEPTACLE. THE SYSTEM WAS TESTED AND FOUND TO BE WORKING AS INTENDED AND PUT BACK INTO SERVICE.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE SYSTEM'S PIN WAS BENT WHERE IT HOOKS TO THE CABLE AND CAUSED A COMMUNICATION ERROR MESSAGE AFTER A CASE. NO PT 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