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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHILIPS VOLCANO CORE; SYSTEM, IMAGING, PULSED ECHO, ULTRASONIC

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PHILIPS VOLCANO CORE; SYSTEM, IMAGING, PULSED ECHO, ULTRASONIC Back to Search Results
Model Number CORE01
Device Problem Sharp Edges (4013)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/06/2023
Event Type  malfunction  
Manufacturer Narrative
This case was reviewed and investigated according to the manufacture¿s policy.Blocks a2-a5: no patient involvement.Blocks b6 & b7: no patient involvement.Block c: not applicable.Block d4: lot# and expiration date are not applicable.Blocks d6, d7, & d10: not applicable; no patient involvement.Block h6: based on the returned screen, the probable cause is likely damaged from use.The device integrity can be affected by external factors such as device manipulation, its impact, and applied pressure associated with use and handling.Blocks h7 & h9: do not apply to this submission.Submission of this report does not, in itself, represent a conclusion by the manufacturer and/or authorized representative or the national competent authority that the content of this report is complete or accurate, that the medical device(s) listed failed in any manner and/or that the medical device(s) caused or contributed to an alleged death or deterioration in the state of the health of any person.
 
Event Description
It was reported that the core system touchscreen was shattered.There was no patient present and no user injury reported.The touchscreen monitor was returned for evaluation.Visual inspection confirmed a crack with sharp edges observed.This product problem is being reported in an abundance of caution because the touchscreen monitor has sharp edges that can result in a potential for harm.
 
Manufacturer Narrative
Blocks d and g: street address was updated from "(b)(6)" to "(b)(6)." submission of this report does not, in itself, represent a conclusion by the manufacturer and/or authorized representative or the national competent authority that the content of this report is complete or accurate, that the medical device(s) listed failed in any manner and/or that the medical device(s) caused or contributed to an alleged death or deterioration in the state of the health of any person.
 
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Brand Name
CORE
Type of Device
SYSTEM, IMAGING, PULSED ECHO, ULTRASONIC
Manufacturer (Section D)
PHILIPS VOLCANO
2451 mercantile drive
rancho cordova CA 95670
Manufacturer (Section G)
VOLCANO CORPORATION
2451 mercantile drive
rancho cordova CA 95670
Manufacturer Contact
ayse yarimoglu
2451 mercantile drive
rancho cordova, CA 95742
858720-406
MDR Report Key16777551
MDR Text Key314090400
Report Number2939520-2023-00002
Device Sequence Number1
Product Code IYO
UDI-Device Identifier00845225010300
UDI-Public(01)00845225010300(11)190314(90)989609000071
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K153369
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 08/02/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberCORE01
Device Catalogue Number300004330631
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/30/2023
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received Not provided
Initial Date FDA Received04/20/2023
Supplement Dates Manufacturer ReceivedNot provided
Supplement Dates FDA Received08/02/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured03/14/2019
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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