FDA Adverse Event Malfunction Summary report: N

X8000 LIGHTSOURCE

MDR report key: 2221409 · Received August 16, 2011

Report

Report Number
2936485-2011-00597
Event Type
Malfunction
Date Received
August 16, 2011
Date of Event
August 3, 2011
Report Date
August 3, 2011
Manufacturer
STRYKER ENDOSCOPY SAN JOSE
Product Code
GCT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ADD'L INFO WILL BE PROVIDED ONCE THE INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE UNIT SHUT OFF AFTER BEING ON FOR AN HOUR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 X8000 LIGHTSOURCE LIGHTSOURCE GCT STRYKER ENDOSCOPY SAN JOSE

Patients

Seq Age Sex Outcome Treatment
1 UNK