FDA Adverse Event Malfunction Summary report: N

INTERA 1.5T POWER/PULSAR

MDR report key: 3023248 · Received February 27, 2013

Report

Report Number
3003768277-2013-00008
Event Type
Malfunction
Date Received
February 27, 2013
Report Date
January 29, 2013
Manufacturer
PHILIPS HEALTHCARE - BEST NETHERLANDS
Product Code
LNH
PMA / PMN Number
K001796
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4): (METHOD, RESULTS, CONCLUSIONS) - THE INVESTIGATION IS STILL ONGOING ON THIS EVENT. WHEN THE INVESTIGATION IS COMPLETED A FOLLOW-UP REPORT WILL BE SENT TO THE FDA.

Description of Event or Problem · 1

THE HEART SENSOR (VECTOR CARDIOGRAM, VCG) IS AN OPTIONAL DEVICE FOR PHILIPS MR SYSTEMS AND IS USED FOR TRIGGERING PURPOSES ONLY, TO CREATE AN IMAGE THAT IS NOT DISTURBED BY HEART MOTION. THIS VCG SENSOR IS A WIRELESS DEVICE AND POWERED BY A BATTERY. THE CUSTOMER REPORTED THAT THE VCG BATTERY WAS PLACED IN THE BATTERY CHARGER AND DURING CHARGING THE BATTERY IGNITED AND CAUGHT FIRE. THE CUSTOMER REMOVED THE POWER SUPPLY CABLE AND THE FIRE EXTINGUISHED SLOWLY. NOBODY WAS INJURED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
84753 INTERA 1.5T POWER/PULSAR LNH PHILIPS HEALTHCARE - BEST NETHERLANDS 781105

Patients

Seq Age Sex Outcome Treatment
1