FDA Adverse Event Malfunction Summary report: N

QUANTA SYSTEM S.P.A.

MDR report key: 3945461 · Received July 1, 2014

Report

Report Number
3004378299-2014-00046
Event Type
Malfunction
Date Received
July 1, 2014
Date of Event
May 16, 2014
Report Date
June 30, 2014
Manufacturer
QUANTA SYSTEM, S.P.A.
Product Code
GEX
PMA / PMN Number
K091909
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PROBLEM WAS DUE TO A BROKEN COMPACT CHARGER. AFTER THE REPLACEMENT OF THIS COMPONENT, THE LASER SYSTEM RESTARTED TO WORK. WE ARE UNAWARE ABOUT PT INJURY.

Description of Event or Problem · 1

THE LASER SYSTEM HAS THE FOLLOWING PROBLEM: "THE LASER HAS NO FUNCTION: NO LIGHT, NO DISPLAY, NO SOUND."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
381960 QUANTA SYSTEM S.P.A. SURGICAL LASER GEX QUANTA SYSTEM, S.P.A. LITHO

Patients

Seq Age Sex Outcome Treatment
1