FDA Adverse Event
Malfunction
Summary report: N
ALLURA XPER FD
MDR report key: 23107492
·
Received September 22, 2025
Report
- Report Number
- 3003768277-2025-010760
- Event Type
- Malfunction
- Date Received
- September 22, 2025
- Date of Event
- May 4, 2022
- Report Date
- September 22, 2025
- Manufacturer
- PHILIPS MEDICAL SYSTEMS NEDERLAND B.V.
- Product Code
- OWB
- PMA / PMN Number
- K162859
- Removal / Correction Number
- C&R#: 3003768277-06/23/2
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SP
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
THIS REPORT WAS SUBMITTED IN AGREEMENT WITH FDA FOR THE RETROSPECTIVE REPORTING COMMITMENT (REFERENCE: (B)(4)) AND IS RELATED TO AND OCCURRED PRIOR TO C&R#: 3003768277-06/23/2023-004-C.
Description of Event or Problem · 0
IT WAS REPORTED TO PHILIPS THAT 'PEDAL CHARGER NOT WORKING'. THIS IS CONNECTED TO LOSS OF IMAGE RELATED TO A ALLURA XPER FD20. THERE WAS NO REPORTED PATIENT OR USER HARM.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2069777 | ALLURA XPER FD | INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM | OWB | PHILIPS MEDICAL SYSTEMS NEDERLAND B.V. | ALLURA XPER FD20 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |