FDA Adverse Event Malfunction Summary report: N

INSTATRAK 3500

MDR report key: 2240987 · Received August 17, 2011

Report

Report Number
1720753-2011-09406
Event Type
Malfunction
Date Received
August 17, 2011
Date of Event
June 11, 2009
Report Date
August 16, 2011
Manufacturer
GE OEC MEDICAL SYSTEMS (SLC)
Product Code
LLZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE GE SERVICE CONDUCTED AN ONSITE INVESTIGATION. THE TRANSMITTER WAS REPLACED, CALIBRATED, AND VERIFIED. THE SYSTEM WAS TESTED AND OPERATES AS INTENDED. DURING A RETROSPECTIVE REVIEW THIS EVENT WAS DETERMINED TO BE REPORTABLE. IT WAS INCLUDED AS PART OF A RETROSPECTIVE SUMMARY REPORT (RSR) REQUEST TO FDA ON APRIL 26, 2011 (B)(4). FDA REQUESTED THIS EVENT TO BE REMOVED FROM THE RSR REQUEST AND FILED VIA 3500A.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE SYSTEM WOULD TRACK. NO PT INJURY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INSTATRAK 3500 RADIOLOGICAL IMAGE PROCESSING LLZ GE OEC MEDICAL SYSTEMS (SLC) INSTATRAK 3500

Patients

Seq Age Sex Outcome Treatment
1