BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    9900

    MDR report key: 2896175 · Received December 10, 2012

    Report

    Report Number
    1720753-2012-10260
    Event Type
    Malfunction
    Date Received
    December 10, 2012
    Date of Event
    November 28, 2012
    Report Date
    December 10, 2012
    Manufacturer
    GE OEC MEDICAL SYSTEMS (SLC)
    Product Code
    JAA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    A GE SERVICE REPRESENTATIVE PERFORMED AN ON SITE INVESTIGATION. THE REPORTED ISSUE COULD NOT BE DUPLICATED. THE LEMO CONNECTOR 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

    THE CUSTOMER REPORTED THAT THE SCREEN FLICKERED AND THE FLUORO IMAGE APPEARED AS IF IT WAS CUT IN HALF. THE IMAGE QUALITY WAS DEGRADED TO A POINT IN WHICH THEY WERE NOT USABLE. THERE WAS NO PATIENT INJURY OR DEATH REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 9900 FLUOROSCOPIC X-RAY JAA GE OEC MEDICAL SYSTEMS (SLC) 9900

    Patients

    Seq Age Sex Outcome Treatment
    1