POLYDOROS *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2012-10-25 for POLYDOROS * manufactured by Siemans Medical.

Event Text Entries

[2948274] X-ray tube in fluoro room not working. Can't be moved to perform procedures.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2814280
MDR Report Key2814280
Date Received2012-10-25
Date of Report2012-10-25
Date of Event2012-09-21
Report Date2012-10-25
Date Reported to FDA2012-10-25
Date Added to Maude2012-11-01
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NamePOLYDOROS
Generic NameSYSTEM, X-RAY, FLUOROSCOPY
Product CodeIZO
Date Received2012-10-25
Model Number*
Catalog Number*
Lot Number*
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Sequence No1
Device Event Key0
ManufacturerSIEMANS MEDICAL
Manufacturer Address51 VALLEY STREAM PKWY MALVERN PA 19355 US 19355


Patients

Patient NumberTreatmentOutcomeDate
10 2012-10-25

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