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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHILIPS ULTRASOUND, INC EPIQ ELITE; SYSTEM, IMAGING, PULSED DOPPLER, ULTRASONIC

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PHILIPS ULTRASOUND, INC EPIQ ELITE; SYSTEM, IMAGING, PULSED DOPPLER, ULTRASONIC Back to Search Results
Model Number EPIQ ELITE ULTRASOUND SYSTEM
Medical Device Problem Code Unintended System Motion (1430)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/17/2023
Type of Reportable Event Malfunction
Event or Problem Description
The customer reported the top half of the epiq elite ultrasound system is not locking, swivels all around while transporting the unit within the user facility.The failure occurred outside of clinical use and no patient or user was harmed as a result of the issue.
 
Additional Manufacturer Narrative
A philips service engineer reseated the articulation arm solenoid to repair the system.A thorough investigation was performed to identify the root cause of the reported issue.The engineering team determined the failure was caused by a hardware issue in the articulating arm latching mechanism preventing the locking solenoid from fully engaging.This action was reported to fda per 21 cfr part 806 on 7/16/21.Reference corrections and removal report number 3019216-07/16/21-002-c.
 
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Brand Name
EPIQ ELITE
Common Device Name
SYSTEM, IMAGING, PULSED DOPPLER, ULTRASONIC
Manufacturer (Section D)
PHILIPS ULTRASOUND, INC
22100 bothell everett highway
bothell WA 98021
Manufacturer (Section G)
PHILIPS ULTRASOUND, INC
22100 bothell everett highway
bothell WA 98021
Manufacturer Contact
thuy nguyen
22100 bothell everett highway
bothell, WA 98021
MDR Report Key16901060
Report Number3019216-2023-00062
Device Sequence Number15158209
Product Code IYN
UDI-Device Identifier00884838099111
UDI-Public00884838099111
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
K200304
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Biomedical Engineer
Type of Report Initial
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 NumberEPIQ ELITE ULTRASOUND SYSTEM
Device Catalogue Number795234
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 04/17/2023
Initial Report FDA Received Date05/10/2023
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
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
3019216-07/16/21-002-C
Patient Sequence Number1
Patient SexUnknown
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