MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2014-09-19 for HARMONY IQ 2800 INTEGRATION SYSTEM manufactured by Vts Medical Systems.
[17990090]
(b)(4).
Patient Sequence No: 1, Text Type: D, B5
[18395733]
Investigation of this event is currently in process. A follow-up report will be submitted when additional information becomes available.
Patient Sequence No: 1, Text Type: N, H10
[30057485]
A steris service specialist arrived at the facility, inspected the integration system and determined the issue was caused by improper grounding on the hd in light video cables. The technician replaced the monitor and corrected the grounding issue on the hd in light camera. No further interference issues have been reported.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1000404456-2014-00007 |
| MDR Report Key | 4102782 |
| Report Source | 05 |
| Date Received | 2014-09-19 |
| Date of Report | 2014-09-19 |
| Date of Event | 2014-02-12 |
| Date Mfgr Received | 2014-08-22 |
| Date Added to Maude | 2014-09-30 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | MS. KATHRYN CADORETTE |
| Manufacturer Street | 5960 HEISLEY ROAD |
| Manufacturer City | MENTOR OH 44060 |
| Manufacturer Country | US |
| Manufacturer Postal | 44060 |
| Manufacturer Phone | 4403927231 |
| Manufacturer G1 | VTS MEDICAL SYSTEMS |
| Manufacturer Street | 40 MELVILLE PARK RD |
| Manufacturer City | MELVILLE NY 11747 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 11747 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | HARMONY IQ 2800 INTEGRATION SYSTEM |
| Generic Name | INTEGRATION SYSTEM |
| Product Code | LMD |
| Date Received | 2014-09-19 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | VTS MEDICAL SYSTEMS |
| Manufacturer Address | 40 MELVILLE PARK RD MELVILLE NY 11747 US 11747 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2014-09-19 |