BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TOSHIBA

    MDR report key: 507199 · Received December 29, 2003

    Report

    Report Number
    MW1030761
    Event Type
    Malfunction
    Date Received
    December 29, 2003
    Date of Event
    November 23, 2003
    Report Date
    December 26, 2003
    Manufacturer
    TOSHIBA MEDICAL SYSTEMS
    Product Code
    IZI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    OTHER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TOSHIBA CATH LAB IZI TOSHIBA MEDICAL SYSTEMS DC-100G *

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR Other