FDA Adverse Event Malfunction Summary report: N

9800

MDR report key: 3792120 · Received January 8, 2014

Report

Report Number
1720753-2014-00288
Event Type
Malfunction
Date Received
January 8, 2014
Date of Event
December 12, 2013
Report Date
January 8, 2014
Manufacturer
GE OEC MEDICAL SYSTEMS (SLC)
Product Code
JAA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A GE SERVICE REPRESENTATIVE PERFORMED AN ONSITE INVESTIGATION. THE WORKSTATION HANDLE WAS EVALUATED AND REPLACED. THE SYSTEM WAS TESTED AND FOUND TO BE WORKING AS INTENDED AND RETURNED TO SERVICE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE BOLT HOLDING THE REAR OF THE HANDLE BROKE OR WAS SHEARED FLUSH WITH THE END OF THE HANDLE. THERE IS NO REPORT OF INJURY OR DEATH ASSOCIATED WITH THE EVENT DESCRIBED IN THIS COMPLAINT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
12476 9800 FLUOROSCOPIC X-RAY JAA GE OEC MEDICAL SYSTEMS (SLC) 9800

Patients

Seq Age Sex Outcome Treatment
1