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MAUDE Adverse Event Report:; X-RAY MACHINE
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; X-RAY MACHINE
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Device Problem
No Display/Image (1183)
Patient Problem
No Known Impact Or Consequence To Patient (2692)
Event Date
03/28/2017
Event Type
malfunction
Event Description
Was doing a chest x-ray and exposed for the first view.Machine exposed, but the image did not appear.
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Type of Device
X-RAY MACHINE
MDR Report Key
6672911
MDR Text Key
78575627
Report Number
6672911
Device Sequence Number
1
Product Code
KPR
Combination Product (y/n)
N
Reporter Country Code
US
Number of Events Reported
1
Summary Report (Y/N)
N
Report Source
User Facility
Reporter Occupation
Risk Manager
Type of Report
Initial
Report Date
06/19/2017
1
Device was Involved in the Event
1
Patient was Involved in the Event
Date FDA Received
06/28/2017
Is this an Adverse Event Report?
No
Is this a Product Problem Report?
Yes
Device Operator
No Information
Was Device Available for Evaluation?
Yes
Is the Reporter a Health Professional?
No
Was the Report Sent to FDA?
Yes
Date Report Sent to FDA
06/19/2017
Event Location
Hospital
Date Report to Manufacturer
06/19/2017
Was Device Evaluated by Manufacturer?
Device Not Returned to Manufacturer
Type of Device Usage
N
Patient Sequence Number
1
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