AXIOM MULTIX TOP 475517

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-02-24 for AXIOM MULTIX TOP 475517 manufactured by Siemens Gmbh.

Event Text Entries

[39424510] The system was brought back to specifications. The reported issue is under investigation and a supplemental report will be submitted if additional information becomes available. This report was submitted february 24, 2016. Customer's address: (b)(6).
Patient Sequence No: 1, Text Type: N, H10


[39424511] During a routine system maintenance, siemens service team discovered that all m8 screws on the transverse carriage were missing and 3 out of 4 bolts were loose. The unit was immediately brought back to specifications and "safe to use" state. There are no injuries associated with this event. The report event occurred in (b)(6).
Patient Sequence No: 1, Text Type: D, B5


[54437752] The investigation of the provided issue showed that the screws were retained with loctite however not completely tightened with torque. Due to the low pre-load of the bolted joints a relative movement (play) between rail and supporting plate exists. This relative movement resulted in another move-behavior of the connection component and led to loosening of the bolted joints. Due to the not strongly tightened bolted joints of the transverse carriage a displacement of the trolley is possible. This is only possible if all screws of the supporting plates are not properly bolted and all locking pins are released off the rail. Therefore the displaced trolley at the transverse carriage could slide off the rail. There was no displacement of the trolley at the concerned customer site. The factory installation team discovered the loose screws during a site visit for a planned service interaction and the issue was addressed internally. A single workmanship error in production was identified as a root cause for the loosened screws. A systematic failure in production can be excluded as systems in the field were checked and no failure could be determined. Furthermore the maintenance records were checked as well and no abnormalities could be identified. For prevention of this issue an additional step was appended in the maintenance instruction. Siemens will continue to systematically check maintenance records.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2240869-2016-00698
MDR Report Key5457095
Date Received2016-02-24
Date of Report2016-01-29
Date of Event2016-01-27
Date Mfgr Received2016-08-17
Date Added to Maude2016-02-24
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 FDA3
Event Location3
Manufacturer ContactANASTASIA SOKOLOVA
Manufacturer Street40 LIBERTY BLVD, MC 65-1A
Manufacturer CityMALVERN 19355
Manufacturer CountryUS
Manufacturer Postal19355
Manufacturer Phone6104486478
Manufacturer G1SIEMENS GMBH
Manufacturer StreetSIEMENSSTRASSE 1
Manufacturer CityFORCHHEIM, 91301
Manufacturer CountryGM
Manufacturer Postal Code91301
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameAXIOM MULTIX TOP
Generic NameTABLE, RADIOGRAPHIC, NON-TILTING, POWERED
Product CodeIZZ
Date Received2016-02-24
Model Number475517
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerSIEMENS GMBH
Manufacturer AddressSIEMENSSTRASSE 1 FORCHHEIM, 91301 GM 91301


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2016-02-24

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