BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    9800

    MDR report key: 2820413 · Received October 31, 2012

    Report

    Report Number
    1720753-2012-08939
    Event Type
    Malfunction
    Date Received
    October 31, 2012
    Date of Event
    October 19, 2012
    Report Date
    October 31, 2012
    Manufacturer
    GE OEC MEDICAL SYSTEMS (SLC)
    Product Code
    JAA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    A GE SERVICE REPRESENTATIVE PERFORMED AN ON SITE INVESTIGATION. THE INTERCONNECT CABLE WAS REPLACED DURING THE SERVICE CALL. THE SYSTEM WAS TESTED AND FOUND TO BE WORKING AS INTENDED AND PUT BACK INTO SERVICE.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE SYSTEM HAD INTERMITTENT VIDEO. THIS ISSUE WILL CAUSE THE SYSTEM TO BE UNUSABLE DUE TO THE INTERMITTENT LOSS OF LIVE IMAGE. THERE IS NO REPORT OF PT INJURY OR DEATH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 9800 FLUOROSCOPIC X-RAY JAA GE OEC MEDICAL SYSTEMS (SLC) 9800

    Patients

    Seq Age Sex Outcome Treatment
    1