BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    9900

    MDR report key: 2260048 · Received August 26, 2011

    Report

    Report Number
    1720753-2011-21411
    Event Type
    Malfunction
    Date Received
    August 26, 2011
    Date of Event
    August 8, 2011
    Report Date
    August 26, 2011
    Manufacturer
    GE OEC MEDICAL SYSTEMS (SLC)
    Product Code
    JAA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    A GE REP EVALUATED THE SYSTEM AND ADJUSTED THE MONITOR POWER SUPPLY. SYSTEM OPERATES AS INTENDED.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THE SYSTEM INTERMITTENTLY WILL NOT DISPLAY AN IMAGE ON THE LEFT MONITOR. 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