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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: INVIVO, A DIVISION OF PHILIPS MEDICAL SYSTEMS EXPRESSION INFORMATION PORTAL (IP5)

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INVIVO, A DIVISION OF PHILIPS MEDICAL SYSTEMS EXPRESSION INFORMATION PORTAL (IP5) Back to Search Results
Model Number 865471
Medical Device Problem Code Application Program Freezes or Fails to Launch (4031)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/16/2021
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
A follow up report will be submitted once the investigation is complete.
 
Event or Problem Description
The customer contacted the customer care solution center and alleged that the touch screen on the complaint device locks up and that the system did not respond.The customer then requested support.The device was reported to be in use on a patient, but no adverse event to patient or user was reported.
 
Event or Problem Description
It was reported that the touch screen on the complaint device locked up and that the system did not respond.The device was reported to be in use on a patient, but no adverse event to the patient or user was reported.
 
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Brand Name
EXPRESSION INFORMATION PORTAL (IP5)
Common Device Name
EXPRESSION INFORMATION PORTAL (IP5)
Manufacturer (Section D)
INVIVO, A DIVISION OF PHILIPS MEDICAL SYSTEMS
12151 research parkway
orlando FL 32826
Manufacturer (Section G)
INVIVO, A DIVISION OF PHILIPS MEDICAL SYSTEMS
12151 research parkway
orlando FL 32826
Manufacturer Contact
tara mackinnon
222 jacobs st
cambridge, MA 02141
6172455900
MDR Report Key12586689
Report Number1051786-2021-10057
Device Sequence Number3289292
Product Code MWI
UDI-Device Identifier00884838031890
UDI-Public00884838031890
Combination Product (Y/N)N
Initial Reporter StateKS
Initial Reporter CountryUS
PMA/510(K) Number
K131382
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,User Facility
Initial Reporter Occupation Biomedical Engineer
Type of Report Initial,Followup
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
Operator of Device Health Professional
Device Model Number865471
Device Catalogue Number865471
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/16/2021
Supplement Date Received by Manufacturer09/16/2021
Initial Report FDA Received Date10/06/2021
Supplement Report FDA Received Date12/15/2021
Was Device Evaluated by Manufacturer? (Y/N) Yes
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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