FDA Adverse Event Malfunction Summary report: N

AXIOM ARTIS ZEE BIPLANE

MDR report key: 2445496 · Received February 6, 2012

Report

Report Number
2240869-2012-00010
Event Type
Malfunction
Date Received
February 6, 2012
Date of Event
January 15, 2012
Report Date
January 15, 2012
Manufacturer
SIEMENS MEDICAL SOLUTIONS USA, INC.
Product Code
IZI
PMA / PMN Number
K073290
Removal / Correction Number
2240869-01/16/12-0001-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SIEMENS IS RELEASING A CUSTOMER SAFETY INFO LETTER TO INFORM CUSTOMERS OF A POTENTIAL MISALIGNMENT IN THE CONNECTION OF THE REMOTE FOOT SWITCH AND THE STATIONARY UNIT. IT WAS DISCOVERED THAT UNDER CERTAIN CIRCUMSTANCES THE WIRELESS FOOT SWITCH WILL LOOSE ITS CONNECTION TO THE AXIOM ARTIS OR ARTIS ZEE AND THE X-RAY RELEASE WITH THE WIRELESS FOOT SWITCH MAY NOT OCCUR. ANY X-RAY RELEASE FROM A WIRED FOOT SWITCH OR HAND SWITCH IS NOT AFFECTED. THE REPORTED POTENTIAL MALFUNCTION MAY OCCUR IF EITHER THE WIRELESS FOOT SWITCH OR THE STATIONARY UNIT IS EQUIPPED WITH IMPROPER FIRMWARE INSTALLED IN THE BLUETOOTH INTERFACE PERFORMING THE COMMUNICATION BETWEEN FOOT SWITCH AND SYSTEM. THE REPORTED MALFUNCTION IS NOT A GENERAL MALFUNCTION, AS A VENDOR UNSYSTEMATICALLY PROVIDED THE IMPROPER FIRMWARE. THERE ARE NO RISKS ASSOCIATED TO PTS PREVIOUSLY PROCESSED OR TREATED WITH THESE SYSTEMS. THE POTENTIAL PROBLEM WILL BE ELIMINATED BY EXCHANGE OF ALL COMPONENTS ON THE SYSTEMS ON WHICH THE IMPROPER FIRMWARE MAY BE INSTALLED. THE APPROPRIATE CORRECTIVE ACTION IS PROVIDED TO THE FIELD AS UI AX044/11/S "REPLACEMENT OF WIRELESS FOOT SWITCH MODULES". IN RESPONSE, SIEMENS HAVE ISSUED A CUSTOMER SAFETY INFO TO AFFECTED CUSTOMERS AS WELL AS A FIX FOR THIS POTENTIAL ISSUE VIA UPDATE INSTRUCTIONS AX046/11/S AND AX044/11/S. THE UPDATE INSTRUCTIONS WERE REPORTED TO THE FDA UNDER 2240869-01/16/12-0001-C.

Description of Event or Problem · 1

IT WAS REPORTED TO SIEMENS THAT THE WIRELESS FOOT SWITCH MALFUNCTIONED DURING AN EXAM. THERE WERE NO INJURIES REPORTED. FACTORY EXPERTS INVESTIGATED THE ISSUE, AND FOUND THAT THE WIRELESS FOOTSWITCH MALFUNCTIONED AND LOST COMMUNICATION WITH THE MAIN SYSTEM UNIT. AS A RESULT, X-RAY RELEASE IS NO LONGER POSSIBLE ALTHOUGH THE SYSTEM STILL INDICATES ITS READINESS. THIS CONDITION MAY CAUSE A DELAY IN THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AXIOM ARTIS ZEE BIPLANE SYSTEM, X-RAY, ANGIOGRAPHIC IZI SIEMENS MEDICAL SOLUTIONS USA, INC. 10094141 NA

Patients

Seq Age Sex Outcome Treatment
1 Other