BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    9900

    MDR report key: 3210015 · Received July 3, 2013

    Report

    Report Number
    1720753-2013-07866
    Event Type
    Malfunction
    Date Received
    July 3, 2013
    Date of Event
    June 24, 2013
    Report Date
    July 3, 2013
    Manufacturer
    GE OEC MEDICAL SYSTEMS (SLC)
    Product Code
    JAA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    A GE SERVICE REPRESENTATIVE PERFORMED AN ON SITE INVESTIGATION. THE CONNECTORS WERE RESEATED AND THE POWER SUPPLY 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, "NO PICTURE ON THE LEFT SIDE OF THE MONITOR. THIS IS A LOSS OF LIVE IMAGE AS THE LEFT MONITOR DISPLAYS THE LIVE FLUOROSCOPY IMAGE. THERE IS NO REPORT OF PATIENT INJURY OR DEATH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    303978 9900 FLUOROSCOPIC X-RAY JAA GE OEC MEDICAL SYSTEMS (SLC) 9900

    Patients

    Seq Age Sex Outcome Treatment
    1