BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    QUANTA SYSTEM

    MDR report key: 3232318 · Received December 18, 2012

    Report

    Report Number
    3004378299-2011-00021
    Event Type
    Malfunction
    Date Received
    December 18, 2012
    Date of Event
    May 12, 2011
    Report Date
    December 14, 2011
    Manufacturer
    QUANTA SYSTEM SPA
    Product Code
    GEX
    PMA / PMN Number
    K090962
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    MECHANICAL PROBLEM ON THE FOOTSWITCH. IT WAS NOT ABLE TO ACTIVATE THE LASER SYSTEM. FOOTSWITCH SUBSTITUTED AND WORKING PERFECTLY WITH THE DEVICE.

    Description of Event or Problem · 1

    IN SURGICAL LASER, NO LASER OUTPUT WHEN FOOTSWITCH IS PRESSED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 QUANTA SYSTEM SURGICAL LASER GEX QUANTA SYSTEM SPA CYBER TM 120

    Patients

    Seq Age Sex Outcome Treatment
    1