FDA Adverse Event Malfunction Summary report: N

DIGITAL RADIOGRAPHY CXDI-70C WIRELESS

MDR report key: 2802651 · Received October 19, 2012

Report

Report Number
1000181430-2012-00052
Event Type
Malfunction
Date Received
October 19, 2012
Report Date
September 13, 2012
Manufacturer
CANON, INC.
Product Code
MQB
PMA / PMN Number
K102012
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). INVESTIGATION IS STILL IN PROGRESS. IF ADDITIONAL INFO IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED PER 21 CFR 803.56. (B)(4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT AN IMAGE WAS NOT CAPTURED. IT IS POSSIBLE THAT THE IMAGE WAS RETAKEN, RESULTING IN UNINTENDED RADIATION EXPOSURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DIGITAL RADIOGRAPHY CXDI-70C WIRELESS MQB CANON, INC. CXDI-70C WIRELESS NA

Patients

Seq Age Sex Outcome Treatment
1 UNK