BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DIGITAL RADIOGRAPHY CXDI-50G

    MDR report key: 2897129 · Received December 31, 2012

    Report

    Report Number
    1000181430-2012-00142
    Event Type
    Malfunction
    Date Received
    December 31, 2012
    Report Date
    April 11, 2011
    Manufacturer
    CANON, INC
    Product Code
    MQB
    PMA / PMN Number
    K031447
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THIS MDR IS BEING SUBMITTED RETROACTIVELY AS A RESULT OF AN INTERNAL AUDIT OF COMPLAINT FILES CONDUCTED BY (B)(4). THE CABLE WAS REPLACED BY THE HOSPITAL STAFF, WHICH MAY HAVE DAMAGED THE SENSOR INTERNALLY. THE SERVICE ENGINEER REQUESTED THAT THE HOSPITAL RETURN TH PANEL. INTERNAL INSPECTION OF THE SENSOR PANEL FOUND A LOOSE SCREW ON THE A/D PC BOARD. THE SERVICE ENGINEER PERFORMED THE CALIBRATION AND SELF TESTS. (B)(4).

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED LINE ARTIFACTS ON THE IMAGE. NO FURTHER INFORMATION WAS PROVIDED. 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-50G MQB CANON, INC CXDI-50G NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK