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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHILIPS MEDICAL SYSTEMS DMC GMBH DIGITALDIAGNOST C90 FLEX/VALUE/CHEST/EMERGENCY ROOM; SOLID STATE X-RAY IMAGER (FLAT PANEL/DIGITAL IMAGER)

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PHILIPS MEDICAL SYSTEMS DMC GMBH DIGITALDIAGNOST C90 FLEX/VALUE/CHEST/EMERGENCY ROOM; SOLID STATE X-RAY IMAGER (FLAT PANEL/DIGITAL IMAGER) Back to Search Results
Model Number 712035
Medical Device Problem Codes Device Handling Problem (3265); Device Fell (4014)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/19/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Ref.Id: (b)(4) the investigation is still ongoing on this event.When the investigation is completed a follow-up report will be sent to the fda.
 
Event or Problem Description
The issue reported was that the portable detector stopped communicating with the equipment after a fall.There's no allegation of death or serious injury.Based on the available information, this issue has been determined not to be a reportable event.Philips has started the investigation of this event.
 
Additional Manufacturer Narrative
Ref.Id: (b)(4).The digitaldiagnost c90 is a stationary x-ray system for general radiographic purposes.As an option, a portable digital flat panel detector (model "skyplate") can be used for image capture.The local field service engineer (fse) went on site, checked the detector.The affected detector needs to be replaced.Installation, including configuration and calibration of the new wireless detector with success.Finally, the system meets the specification for the performed service and is returned to use.No details were provided about the circumstances when the detector fell down.As the customer did not make other claims, it is concluded that the detector was dropped by accident (use error).Risk estimation revealed acceptable risk per risk benefit analysis, because actually, there is no feasible technical solution for this kind of ¿use error¿.This issue is further monitored and trended.
 
Event or Problem Description
The customer reported that after a fall the portable detector stopped the communicating with the system.A dropped detector can lead in worst case to a fracture in the foot.No injury reported.
 
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Brand Name
DIGITALDIAGNOST C90 FLEX/VALUE/CHEST/EMERGENCY ROOM
Common Device Name
SOLID STATE X-RAY IMAGER (FLAT PANEL/DIGITAL IMAGER)
Manufacturer (Section D)
PHILIPS MEDICAL SYSTEMS DMC GMBH
roentgenstrasse 24
hamburg 22335
GM  22335
Manufacturer (Section G)
PHILIPS MEDICAL SYSTEMS DMC GMBH
roentgenstrasse 24
hamburg 22335
GM   22335
Manufacturer Contact
dusty leppert
100 park avenue, suite 300
orange village, OH 44122
MDR Report Key19317490
Report Number3003768251-2024-00029
Device Sequence Number20745430
Product Code MQB
UDI-Device Identifier00884838090705
UDI-Public00884838090705
Combination Product (Y/N)N
Initial Reporter CountryPO
PMA/510(K) Number
K182973
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 06/24/2024
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 Number712035
Device Catalogue Number712035
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 04/19/2024
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date05/15/2024
Supplement Report FDA Received Date06/24/2024
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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