FDA Adverse Event Malfunction Summary report: N

WALKAWAY 96 PLUS

MDR report key: 3960853 · Received June 27, 2014

Report

Report Number
2919016-2014-00027
Event Type
Malfunction
Date Received
June 27, 2014
Date of Event
March 28, 2014
Report Date
May 28, 2014
Manufacturer
SIEMENS HEALTHCARE DIAGNOSTICS
Product Code
LRG
Removal / Correction Number
2919016-06/09/14-001-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4) - PRODUCT QUALITY ISSUE ASSOCIATED WITH AN INHERENT DEVICE AND/OR DEVICE COMPONENT CHARACTERISTIC THAT IS NOT SATISFACTORY AS SPECIFIC OR DELIVERED. SIEMENS HEALTHCARE DIAGNOSTICS INC. CONDUCTED A FIELD CORRECTION, INTERNAL NUMBER (B)(4). A WRITTEN CUSTOMER NOTIFICATION WAS SENT ON 06/2014 TO ALL CUSTOMERS AFFECTED NOTIFYING THEM OF THE SPRINGS CONTAINED IN THE ACCESS DOOR HINGE ASSEMBLY ON THE WALKAWAY PLUS INSTRUMENTS ARE BECOMING DETACHED CAUSING PREMATURE FAILURE OF THE HINGE ASSEMBLY AND A POTENTIAL SAFETY ISSUE FORT THE CUSTOMER. THE NOTIFICATION ALSO INCLUDES ACTIONS TO BE TAKEN BY CUSTOMERS. THE FDA SAN FRANCISCO DISTRICT OFFICE WAS NOTIFIED ON 06/09/2014 OF THE REMEDIAL ACTION (REPORT NO. 2919016-06/09/14-001-C). A SIEMENS REPRESENTATIVE WILL CONTACT THE CUSTOMER OVER THE NEXT FEW MONTHS TO SCHEDULE A VISIT TO CORRECT THIS ISSUE WITH THE ACCESS DOOR HINGE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE BOTTOM HINGE OF THE WALKAWAY PLUS ACCESS DOOR FAILED. THE SPRING DISENGAGED FROM ITS PIN AND LODGED BEHIND THE HINGE SPRING PIN. THE TOP HINGE WAS OPERATIONAL. NO REPORT OF ADVERSE EVENT OR INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
375873 WALKAWAY 96 PLUS WALKAWAY 96 PLUS LRG SIEMENS HEALTHCARE DIAGNOSTICS

Patients

Seq Age Sex Outcome Treatment
1