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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD, INC. (BASD) -3006260740 SITE-RITE 8 SCANNER

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C.R. BARD, INC. (BASD) -3006260740 SITE-RITE 8 SCANNER Back to Search Results
Model Number N/A
Medical Device Problem Codes Failure to Charge (1085); Unexpected Shutdown (4019)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/10/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H11: section a through f - the information provided by bd represents all of the known information at this time.Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.The date of event was not provided by the complainant/reporter, the date reflected in this report is the date bd became aware of the event.The manufacturer has received the sample and it will be evaluated.A supplemental will be submitted with evaluation results.
 
Event or Problem Description
It was reported per rn, "the red battery line on the screen just started to go on, it counts down to 10 and then shuts off.We keep the monitor plugged in overnight.Tried turning it on while plugged in, and the same thing happens.".
 
Additional Manufacturer Narrative
H11: section a through f - the information provided by bd represents all of the known information at this time.Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.The device was returned to the service facility for evaluation.During evaluation, the reported issue of the red battery line on the screen just started to go on, it counts down to 10 and then shuts off was confirmed.The unit¿s charging port is not making connection with the motherboard.The root cause of the reported failure was identified as a material failure of the port.
 
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Brand Name
SITE-RITE 8 SCANNER
Common Device Name
SITE-RITE 8 SCANNER
Manufacturer (Section D)
C.R. BARD, INC. (BASD) -3006260740
605 north 5600 west
salt lake city 84116
Manufacturer (Section G)
DYMAX CORP. -2523003
110 marshall drive
warrendale PA 15086
Manufacturer Contact
kayla bevins
605 north 5600 west
salt lake city 84116
8015950700
MDR Report Key21284580
Report Number3006260740-2025-00246
Device Sequence Number13091459
Product Code IYO
UDI-Device Identifier00801741138287
UDI-Public(01)00801741138287
Combination Product (Y/N)N
Initial Reporter StateCT
Initial Reporter CountryUS
PMA/510(K) Number
K182281
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 04/17/2025
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 NumberN/A
Device Catalogue Number9770600Y
Device Lot NumberN/A
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/23/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/10/2025
Supplement Date Received by Manufacturer04/17/2025
Initial Report FDA Received Date01/31/2025
Supplement Report FDA Received Date05/07/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/01/2016
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
Outcome Attributed to Adverse Event Other;
Patient SexUnknown
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