FDA Adverse Event Malfunction Summary report: N

Q CORE POWER SUPPLY

MDR report key: 4886508 · Received July 1, 2015

Report

Report Number
3010293992-2015-00110
Event Type
Malfunction
Date Received
July 1, 2015
Date of Event
June 17, 2015
Report Date
June 18, 2015
Manufacturer
Q CORE MEDICAL LTD
Product Code
MRZ
PMA / PMN Number
K123049
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). Q CORE MEDICAL LTD (MANUFACTURER) IS SUBMITTING THE REPORT ON BEHALF OF HOSPIRA.

Description of Event or Problem · 1

THE EVENT WAS REPORTED BY A CUSTOMER FROM USA: "TWO POWER CORDS BROKEN. DELAY IN THERAPY: NO NEED FOR MEDICAL INTERVENTION: NO".

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
427478 Q CORE POWER SUPPLY POWER SUPPLY MRZ Q CORE MEDICAL LTD POWER SUPPLY 2014

Patients

Seq Age Sex Outcome Treatment
1