FDA Adverse Event Malfunction Summary report: N

3.0T DISCOVERY MR750W

MDR report key: 5845191 · Received August 3, 2016

Report

Report Number
2183553-2016-00016
Event Type
Malfunction
Date Received
August 3, 2016
Date of Event
July 8, 2016
Report Date
September 16, 2016
Manufacturer
GE MEDICAL SYSTEMS, LLC
Product Code
LNH
PMA / PMN Number
K130115
Removal / Correction Number
2183553-06/15/16-001-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
RADIOLOGIC TECHNOLOGIST

Narratives

Additional Manufacturer Narrative · 1

GE HEALTHCARE'S INVESTIGATION HAS DETERMINED THAT THE CABLE MODE PRESENT IN THE DESIGN OF THE MR750W RF BODY COIL IS THE ROOT CAUSE OF ARCING THAT HAS LED TO EXCESS HEAT/DISCOLORATION OF THE SURFACE OF THE PATIENT BORE. GE HEALTHCARE IS INITIATING AN ACTION IN THE FIELD TO INSPECT UNITS TO DETERMINE WHICH UNITS HAVE THE POTENTIAL CABLE MODE, AND MAKE ANY CORRECTIONS IF NECESSARY. THIS ACTION WAS REPORTED TO THE FDA UNDER CORRECTION NUMBER 2183553-06/15/16-001-C ON JUNE 15, 2016.

Additional Manufacturer Narrative · 1

GE HEALTHCARE'S INVESTIGATION IS ONGOING. A FOLLOW UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION HAS BEEN COMPLETED. DEVICE EVALUATION ANTICIPATED, BUT NOT YET BEGUN.

Description of Event or Problem · 1

IT WAS REPORTED THAT A CUSTOMER CALLED FOR SERVICE DUE TO AN ELECTRICAL SMELL IN THE SCAN ROOM. THE FIELD ENGINEER SAW A VISIBLE BURNED SPOT IN THE MAGNET BORE. NO PATIENT INJURY OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
497642 3.0T DISCOVERY MR750W NUCLEAR MAGNETIC RESONANCE IMAGING LNH GE MEDICAL SYSTEMS, LLC

Patients

Seq Age Sex Outcome Treatment
1 39 YR