HUT EXT DR FINAL ASSY-STANDARD 404008

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06,07 report with the FDA on 2012-02-28 for HUT EXT DR FINAL ASSY-STANDARD 404008 manufactured by Liebel-flarsheim Co..

Event Text Entries

[2394608] (b)(6): customer reports via phone that during an undetermined urology procedure on a female patient, the fluoro failed. Staff moved the patient to another room where the procedure was completed without further incident. Customer did not provide patient or procedural information other than to say the procedure was completed and the patient is fine. No reported injury.
Patient Sequence No: 1, Text Type: D, B5


[9673992] Field service engineer (fse) troubleshot system for cause of system misalignment and found error caused by the transducer pcb. When this error occurred, the system, as designed, would not allow fluoro. Fluoro did not fail as this is a safety interlock. Fse replaced the transducer pcb and verified proper operation. Unit passed checkout procedures and was returned to full service by the customer.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1518293-2012-00029
MDR Report Key2480318
Report Source05,06,07
Date Received2012-02-28
Date of Report2012-02-28
Date of Event2012-02-02
Date Mfgr Received2012-02-02
Device Manufacturer Date2009-08-01
Date Added to Maude2012-08-23
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactDAVID BENSON
Manufacturer Street2111 EAST GALBRAITH RD.
Manufacturer CityCINCINNATI OH 45237
Manufacturer CountryUS
Manufacturer Postal45237
Manufacturer Phone5139485719
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameHUT EXT DR FINAL ASSY-STANDARD
Product CodeKQS
Date Received2012-02-28
Model NumberHUT EXT DR
Catalog Number404008
Lot NumberNA
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerLIEBEL-FLARSHEIM CO.
Manufacturer Address2111 EAST GALBRAITH RD. CINCINNATI OH 45237 US 45237


Patients

Patient NumberTreatmentOutcomeDate
10 2012-02-28

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