BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BUCKY DIAGNOST TH

    MDR report key: 2277072 · Received September 29, 2011

    Report

    Report Number
    3003768251-2011-00070
    Event Type
    Malfunction
    Date Received
    September 29, 2011
    Report Date
    September 6, 2011
    Manufacturer
    PHILIPS MEDICAL SYSTEMS GMBH DMC GMBH
    Product Code
    KPR
    PMA / PMN Number
    K945278
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    WHEN INVESTIGATION IS COMPLETED, A F/U REPORT WILL BE SENT TO THE FDA. (B)(4).

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE COVER FELL OFF WHEN HE WAS POSITIONING THE TUBE CRANE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BUCKY DIAGNOST TH KPR PHILIPS MEDICAL SYSTEMS GMBH DMC GMBH 704030

    Patients

    Seq Age Sex Outcome Treatment
    1