BLUE 30 BLUE30 55002026C

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05,06,07 report with the FDA on 2014-06-04 for BLUE 30 BLUE30 55002026C manufactured by Maquet S.a.s..

Event Text Entries

[17263476] The customer reported to maquet a bulb exploded while examining a patient. No falling components nor injuries were reported. (b)(4).
Patient Sequence No: 1, Text Type: D, B5


[17453572] For a similar event, maquet (b)(4) contacted the supplier of the halogen bulbs for assistance. The supplier reported that they test 100% of the bulbs in a vacuum oven in order to reduce risks of bursting. Continued use of a lamp beyond stated bulb life, an overvoltage or a weakness of the bulb's glass caused by contaminate (e. G. Fingerprint) can lead to the type of failure reported. The blue 30/80 series operating manual includes the following instruction for users: 4. 1 replacing the light bulb attention: do not touch the glass body of the halogen bulb with bare fingers. Replace the bulb every 600 hours. A maquet tech replaced the bulb with a new one and returned the device to service. Should additional info become available, a follow up report will be submitted.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9710055-2014-00041
MDR Report Key3979797
Report Source01,05,06,07
Date Received2014-06-04
Date of Report2014-05-06
Date of Event2014-05-05
Date Facility Aware2014-05-15
Report Date2014-06-04
Date Mfgr Received2014-05-06
Device Manufacturer Date2007-01-01
Date Added to Maude2014-08-12
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationBIOMEDICAL ENGINEER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactJANICE PEVIDE
Manufacturer Street45 BARBOUR POND DRIVE
Manufacturer CityWAYNE NJ 07470
Manufacturer CountryUS
Manufacturer Postal07470
Manufacturer Phone9737097753
Manufacturer G1MAQUET S.A.S.
Manufacturer StreetPARC DE LIMERE AVENUE DE LA POMME DE PIN
Manufacturer CityARDON, ORLEANS CEDEX 2 45074
Manufacturer CountryFR
Manufacturer Postal Code45074
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameBLUE 30
Product CodeFSS
Date Received2014-06-04
Model NumberBLUE30
Catalog Number55002026C
Lot NumberNA
ID Number56077851
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Age7 DA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerMAQUET S.A.S.
Manufacturer AddressORLEANS FR


Patients

Patient NumberTreatmentOutcomeDate
10 2014-06-04

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