INTEGRATED DIGITAL SURGICAL RACK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-05-18 for INTEGRATED DIGITAL SURGICAL RACK manufactured by Black Diamond Video.

Event Text Entries

[109255517] User facility personnel immediately powered down the integrated digital surgical rack. A steris service technician inspected the digital surgical rack and performed troubleshooting activities. The technician identified that the amplifier, a component of the integrated digital surgical rack, shorted causing the reported event to occur. The technician replaced the amplifier, tested the integrated digital surgical rack, and found it to be operating properly. The amplifier subject of the reported event will be returned to steris for evaluation. A follow-up mdr will be submitted should additional information become available.
Patient Sequence No: 1, Text Type: N, H10


[109255518] The user facility reported a burning odor emitting from their integrated digital surgical rack during a patient procedure. A procedure delay occurred as the patient was transferred to another room. The procedure was completed successfully. No report of injury.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3008776287-2018-00001
MDR Report Key7526714
Date Received2018-05-18
Date of Report2018-05-18
Date of Event2018-04-20
Date Mfgr Received2018-04-20
Date Added to Maude2018-05-18
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. DANIEL DAVY
Manufacturer Street5960 HEISLEY ROAD
Manufacturer CityMENTOR OH 44060
Manufacturer CountryUS
Manufacturer Postal44060
Manufacturer Phone4403927453
Manufacturer G1BLACK DIAMOND VIDEO
Manufacturer Street503 CANAL BLVD.
Manufacturer CityRICHMOND CA 94804
Manufacturer CountryUS
Manufacturer Postal Code94804
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameINTEGRATED DIGITAL SURGICAL RACK
Generic NameINTEGRATED DIGITAL SURGICAL RACK
Product CodeFWC
Date Received2018-05-18
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBLACK DIAMOND VIDEO
Manufacturer Address503 CANAL BLVD. RICHMOND CA 94804 US 94804


Patients

Patient NumberTreatmentOutcomeDate
10 2018-05-18

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