FDA Adverse Event Malfunction Summary report: N

SOMATOM DEFINITION FLASH

MDR report key: 3880489 · Received May 7, 2014

Report

Report Number
2240869-2014-03364
Event Type
Malfunction
Date Received
May 7, 2014
Date of Event
April 8, 2014
Report Date
April 11, 2014
Manufacturer
SIEMENS AG MEDICAL SOLUTIONS
Product Code
JAK
PMA / PMN Number
K121072
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SW
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

SIEMENS WAS NOTIFIED OF THE REPORTED ISSUE ON (B)(4)/2014. THIS MDR IS BEING MAILED ON (B)(4) 2014. THE INVESTIGATION IS ON-GOING AND A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION.

Description of Event or Problem · 1

SIEMENS WAS INFORMED ON (B)(4) 2014 THAT PATIENTS HAVE BEEN EXPOSED TO HIGHER RADIATION DOSES THAN NECESSARY DUE TO ECG SIGNAL DISTURBANCES IN A NEWER VERSION OF A PT MONITORING MODULE (PMM2). REPORTEDLY, THE PMM2 HAS BEEN REPLACED WITH AN OLDER VERSION, PMM0 AND THE SYSTEM IS NOW OPERATING AS EXPECTED. THERE IS NO REPORT OF PT INJURY. THIS REPORTED ISSUE OCCURRED IN (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
275565 SOMATOM DEFINITION FLASH SYSTEM, X-RAY, TOMOGRAPHY, COMPUTED JAK SIEMENS AG MEDICAL SOLUTIONS 10430603 NA

Patients

Seq Age Sex Outcome Treatment
1 SW VERSION VA44A_SP2A| PATIENT MONITORING MODULE (PMM2)