BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CABLE, 4 TO 4 PIN CONNECTOR, GVL-424

    MDR report key: 3000166 · Received February 14, 2013

    Report

    Report Number
    9615393-2013-00067
    Event Type
    Malfunction
    Date Received
    February 14, 2013
    Date of Event
    January 16, 2013
    Report Date
    January 16, 2013
    Manufacturer
    VERATHON MEDICAL (CANADA) ULC.
    Product Code
    CCW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    SERVICE RECEIVED THE DEVICE FOR FURTHER EVAL. EVAL RESULTS PENDING ANALYSIS OF THE PRODUCT.

    Description of Event or Problem · 1

    THE CUSTOMER CONTACTED VERATHON INC. REGARDING A BROKEN PIN ON A BLADE CABLE THAT CONNECTS TO THE MONITOR. THE CABLE WAS RETURNED FOR FURTHER EVAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    65120 CABLE, 4 TO 4 PIN CONNECTOR, GVL-424 NONE CCW VERATHON MEDICAL (CANADA) ULC. 0600-0237

    Patients

    Seq Age Sex Outcome Treatment
    1