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U.S. Department of Health and Human Services

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

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PHILIPS ULTRASOUND, INC EPIQ CVX; SYSTEM, IMAGING, PULSED DOPPLER, ULTRASONIC Back to Search Results
Model Number EPIQ DIAGNOSTIC ULTRASOUND SYSTEM
Medical Device Problem Code Unintended System Motion (1430)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/29/2025
Type of Reportable Event Malfunction
Event or Problem Description
A customer reported the swivel mechanism of their epiq cvx ultrasound system¿s control panel did not lock properly 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.A replacement bearing was sent to the customer to resolve the immediate issue.A thorough engineering investigation has been performed to identify the root cause of the reported issue.The engineering team determined the failure was a hardware issue in the articulating arm latching mechanism preventing the locking solenoid from fully engaging.
 
Additional Manufacturer Narrative
H10 philips has started an investigation, and upon completion, a follow-up report will be submitted.H11 the following information was omitted on the initial report.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.
 
Additional Manufacturer Narrative
H10: it was initially reported that the resolution for the customer was that a replacement bearing was sent to the customer, however reseating and applying loctite glue to bushing resolved the immediate issue.The bearing was only shipped directly to customer for use in future repairs.H11: a thorough investigation was performed to determine the cause of the reported problem.It was determined that the application of adhesive was inadequate, allowing for the bearing to become unsecured and preventing the locking solenoid from fully engaging.The system has returned to service with no similar issues reported post repair.
 
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Brand Name
EPIQ CVX
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
roxanne ramirez
22100 bothell everett highway
bothell, WA 98021
9095703538
MDR Report Key22336621
Report Number3019216-2025-000234
Device Sequence Number15707514
Product Code IYN
UDI-Device Identifier00884838097933
UDI-Public(01)00884838097933
Combination Product (Y/N)N
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
K132304
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,Followup,Followup
Report Date (Section B) 07/30/2025
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 NumberEPIQ DIAGNOSTIC ULTRASOUND SYSTEM
Device Catalogue Number795231
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 05/29/2025
Supplement Date Received by Manufacturer05/29/2025
07/02/2025
Initial Report FDA Received Date06/26/2025
Supplement Report FDA Received Date06/26/2025
07/30/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/24/2021
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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