FDA Adverse Event Other Summary report: N

TANDEM D670

MDR report key: 3667032 · Received February 11, 2014

Report

Report Number
9613445-2013-00008
Event Type
Other
Date Received
February 11, 2014
Date of Event
July 15, 2013
Report Date
July 15, 2013
Manufacturer
GE HANGWEI MEDICAL SYSTEMS CO., LTD.
Product Code
KPS
PMA / PMN Number
K093514
Removal / Correction Number
9613299-06/20/2013-004-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE INITIAL MDR WAS FILED UNDER THE INCORRECT MANUFACTURING SITE. THIS REPORT IS TO CORRECT THE MANUFACTURING SITE TO GE HANGWEI MEDICAL SYSTEMS CO, (B)(4). THIS ISSUE WAS IDENTIFIED AS PRESENTING A DIFFERENT FAILURE MODE THAN THE ONE IDENTIFIED IN MDR# 9613299-2013-00001. BASED ON ENGINEERING ANALYSIS THESE LOOS SCREWS DO NOT COMPROMISE THE STRUCTURAL INTEGRITY OF THE COMPONENT AND THEREFORE DO NOT INTRODUCE A HAZARDOUS SITUATION. GE HEALTHCARE'S INVESTIGATION IS ONGOING. A F/U REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION HAS BEEN COMPLETED.

Description of Event or Problem · 1

DURING SERVICE ACTIVITY RELATED TO A FIELD ACTION, A GE HEALTHCARE FIELD ENGINEER FOUND LOOSE SCREWS ON THE LINEAR RAIL. NO ASSOCIATED GAP WAS MEASURED BETWEEN THE RAIL AND ROTOR. NO DETECTOR FALL EVENT AND NO INJURY OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
89954 TANDEM D670 SYSTEM, TOMOGRAPHY, COMPUTED, EMISSION KPS GE HANGWEI MEDICAL SYSTEMS CO., LTD.

Patients

Seq Age Sex Outcome Treatment
1