FDR AQRO DR-XD 1000 N/A

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-02-07 for FDR AQRO DR-XD 1000 N/A manufactured by Fujifilm Corporation.

MAUDE Entry Details

Report Number3001722928-2020-00004
MDR Report Key9681800
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-02-07
Date of Report2020-03-26
Date of Event2020-01-11
Date Mfgr Received2020-01-14
Device Manufacturer Date2018-09-01
Date Added to Maude2020-02-07
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 ContactSAFETY OFFICER
Manufacturer Street798 MIYANODAI KAISEI-MACHI
Manufacturer CityASHIGARAKAMI-GUN, KANAGAWA 002588538
Manufacturer CountryJA
Manufacturer Postal002588538
Manufacturer G1FUJIFILM CORPORATION
Manufacturer Street798 MIYANODAI KAISEI-MACHI ASHIGARAKAMI-GUN
Manufacturer CityKANAGAWA, 002588538
Manufacturer CountryJA
Manufacturer Postal Code002588538
Single Use3
Remedial ActionOT
Previous Use Code3
Removal Correction NumberN/A
Event Type3
Type of Report3

Device Details

Brand NameFDR AQRO
Generic NameMOBILE X-RAY SYSTEM
Product CodeIZL
Date Received2020-02-07
Returned To Mfg2020-01-24
Model NumberDR-XD 1000
Catalog NumberN/A
Lot NumberN/A
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerFUJIFILM CORPORATION
Manufacturer Address798 MIYANODAI KAISEI-MACHI ASHIGARAKAMI-GUN KANAGAWA, 002588538 JA 002588538


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-07

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