FDA Adverse Event Malfunction Summary report: N

DIGITAL RETINAL CAMERA CX-1

MDR report key: 2980347 · Received January 28, 2013

Report

Report Number
1000181430-2013-00027
Event Type
Malfunction
Date Received
January 28, 2013
Report Date
January 17, 2012
Manufacturer
CANON INC.
Product Code
NFJ
PMA / PMN Number
K092565
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS MDR IS BEING SUBMITTED RETROACTIVELY AS A RESULT OF AN INTERNAL AUDIT OF COMPLAINT FILES CONDUCTED BY CANON HEALTHCARE SOLUTIONS USA. (B)(4). THE SERVICE ENGINEER COULD NOT VERIFY THE PROBLEM DURING THE SERVICE EVALUATION. HE REPLACED THE MOTOR ON THE MYD/NON MYD FILTER. HE RETESTED THE SYSTEM AND THE PERFORMANCE WAS OK. (B)(4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THERE WAS AN ARTIFACT IN THE IMAGES. PART OF THE LEFT SIDE OF THE IMAGE WAS DARK. THIS PROBLEM APPEARS INTERMITTENTLY. NO INFORMATION WAS PROVIDED REGARDING WHAT IMAGE TYPES (COLOR, RED-FREE, FLUORESCEIN ANGIOGRAPHY) WERE AFFECTED. THE CUSTOMER DID NOT STATE THAT THE FLUORESCEIN IMAGING WAS REPEATED. HOWEVER, IF THE PROBLEM OCCURRED DURING THE FLUORESCEIN IMAGING PORTION OF THE EXAM, THE TECHNICIAN MAY HAVE RESCHEDULED THE EXAM. A RESCHEDULED EXAM WOULD HAVE INVOLVED A REPEAT INJECTION OF FLUORESCEIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
38364 DIGITAL RETINAL CAMERA CX-1 NFJ CANON INC. CX-1 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK