FDA Adverse Event
Malfunction
Summary report: N
9900
MDR report key: 2223020
·
Received August 10, 2011
Report
- Report Number
- 1720753-2011-20925
- Event Type
- Malfunction
- Date Received
- August 10, 2011
- Date of Event
- August 5, 2011
- Report Date
- August 10, 2011
- Manufacturer
- GE OEC MEDICAL SYSTEMS (SLC)
- Product Code
- JAA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AZ, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
A GE SERVICE REP PERFORMED AN ONSITE INVESTIGATION. THE CONNECTION ON THE POWER SIGNAL INTERFACE BOARD WAS RESEATED WHICH INCREASED THE VOLTAGE ON THE HIGH VOLTAGE PRINTED CIRCUIT BOARD. 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 DURING A PROCEDURE THE SYSTEM DISPLAYED A COMMUNICATION ERROR MESSAGE AND WAS IN CONTINUOUS FLUOROSCOPY MODE. 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 |