BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    QUANTA SYSTEM

    MDR report key: 3232275 · Received December 21, 2012

    Report

    Report Number
    3004378299-2012-00028
    Event Type
    Malfunction
    Date Received
    December 21, 2012
    Date of Event
    October 8, 2012
    Report Date
    December 19, 2012
    Manufacturer
    QUANTA SYSTEM, S.P.A.
    Product Code
    GEX
    PMA / PMN Number
    K102749
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SP
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    ROD DAMAGED. OUTPUT COUPLER MIRROR DAMAGED. TRACES OF HUMIDITY INSIDE RESONATOR. SUBSTITUTED OPTICAL COMPONENTS.

    Description of Event or Problem · 1

    SURGICAL LASER. MAX OUTPUT: 120 W INSTEAD OF 150 W. UNAWARE OF PT INVOLVEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 QUANTA SYSTEM SURGICAL LASER GEX QUANTA SYSTEM, S.P.A. CYBER TM 150

    Patients

    Seq Age Sex Outcome Treatment
    1