FDA Adverse Event
Malfunction
Summary report: N
QUANTA SYSTEM S.P.A.
MDR report key: 3972811
·
Received July 25, 2014
Report
- Report Number
- 3004378299-2014-00053
- Event Type
- Malfunction
- Date Received
- July 25, 2014
- Date of Event
- July 3, 2014
- Report Date
- July 21, 2014
- Manufacturer
- QUANTA SYSTEM, S.P.A.
- Product Code
- GEX
- PMA / PMN Number
- K090962
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TW
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
WE ARE WAITING FOR ADDITIONAL INFORMATION FROM DISTRIBUTOR.
Description of Event or Problem · 1
THE LASER SYSTEM HAS THE FOLLOWING PROBLEM: "RESONATOR DEFECT/LOW POWER FROM RESONATOR".
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 436007 | QUANTA SYSTEM S.P.A. | SURGICAL LASER | GEX | QUANTA SYSTEM, S.P.A. | CYBER TM 120 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |