FDA Adverse Event
Malfunction
Summary report: N
9900
MDR report key: 3821219
·
Received April 16, 2014
Report
- Report Number
- 1720753-2014-03311
- Event Type
- Malfunction
- Date Received
- April 16, 2014
- Date of Event
- April 1, 2014
- Report Date
- April 16, 2014
- Manufacturer
- GE OEC MEDICAL SYSTEMS (SLC)
- Product Code
- JAA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- LA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
A GE SERVICE REP PERFORMED AN ONSITE INVESTIGATION. THE HV STICKS WERE EVALUATED AND CLEANED. THE GENERATOR BATTERIES WERE EVALUATED AND REPLACED. THE J1 COMPONENT ON TANK WAS FOUND LOOSE. THE J1 COMPONENT WAS TIGHTENED. A COMPLETE FILAMENT CALIBRATION WAS PERFORMED. THE SYSTEM WAS TESTED AND FOUND TO BE WORKING AS INTENDED AND RETURNED TO SERVICE. THIS MALFUNCTION MAY HAVE RESULTED IN A POSSIBLE ACCIDENTAL RADIATION OCCURRENCE.
Description of Event or Problem · 1
THE CUSTOMER REPORTED THAT THE SYSTEM EXHIBITED FILAMENT REGULATOR FAILURE ERRORS DURING A PT PROCEDURE. THIS EVENT MAY HAVE RESULTED IN AN ARO (ACCIDENTAL RADIATION OCCURRENCE). NO PT DEATH OR SERIOUS INJURY WAS REPORTED RELATED TO THIS EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 234095 | 9900 | FLUOROSSOPIC X-RAY | JAA | GE OEC MEDICAL SYSTEMS (SLC) | 9900 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |