OPTIFLEX III 2090

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 04,05,06 report with the FDA on 2010-02-11 for OPTIFLEX III 2090 manufactured by Chattanooga Group.

Event Text Entries

[1434263] Complainant reports that device smoked and shorted out.
Patient Sequence No: 1, Text Type: D, B5


[8442487] Per chattanooga group engineering eval of device: "receptacle pulled out of chassis shorting to out. Damaged receptacle replaced and glued in. Replaced power supply as a precaution and hi pot test preformed. Unit passed test preformed after parts replaced. "
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1022819-2009-00182
MDR Report Key1626321
Report Source04,05,06
Date Received2010-02-11
Date of Report2009-11-11
Date of Event2009-11-11
Date Mfgr Received2009-11-11
Date Added to Maude2012-05-18
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMICHAEL TREAS
Manufacturer Street4717 ADAMS RD
Manufacturer CityHIXSON TN 37343
Manufacturer CountryUS
Manufacturer Postal37343
Manufacturer Phone4238707281
Single Use3
Remedial ActionRP
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameOPTIFLEX III
Product CodeBXB
Date Received2010-02-11
Returned To Mfg2010-01-06
Model Number2090
Catalog Number2090
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerCHATTANOOGA GROUP
Manufacturer AddressHIXSON TN US


Patients

Patient NumberTreatmentOutcomeDate
10 2010-02-11

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