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

[2474082] (b)(6): customer reports via phone that they were performing a urology stent and stone removal procedure on an elderly female patient when the monitors failed. Physician used portable x-ray completed. No reported injury.
Patient Sequence No: 1, Text Type: D, B5


[9674898] Field service engineer (fse) reports resolving the static line issue by power cycling the infimed gold one. The image was now clean on the monitors. The customer decided that they wanted no repairs. Fse reported the table a "not to be used". Fse noted in tess that the system is to be replaced and closed the service ticket.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1518293-2012-00028
MDR Report Key2480333
Report Source05,06,07
Date Received2012-02-28
Date of Report2012-02-28
Date of Event2012-02-01
Date Mfgr Received2012-02-01
Device Manufacturer Date2000-10-01
Date Added to Maude2012-08-24
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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