Brand Name | ICT |
Type of Device | SYSTEM, X-RAY, TOMOGRAPHY, COMPUTED |
Manufacturer (Section D) |
PHILIPS MEDICAL SYSTEMS (CLEVELAND), INC. |
595 miner rd |
cleveland OH 44143 |
|
Manufacturer Contact |
derrick
massuri
|
595 miner rd |
cleveland, OH 44143
|
4404833000
|
|
MDR Report Key | 7149166 |
MDR Text Key | 95954785 |
Report Number | 1525965-2017-00159 |
Device Sequence Number | 1 |
Product Code |
JAK
|
Combination Product (y/n) | N |
Reporter Country Code | CH |
PMA/PMN Number | K060937 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
consumer,health professional |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
12/01/2017 |
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
|
Device Operator |
Health Professional
|
Device Model Number | 728306 |
Device Catalogue Number | NCTC780 |
Other Device ID Number | N/A |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
Yes
|
Was the Report Sent to FDA? |
No
|
Initial Date Manufacturer Received |
12/01/2017 |
Initial Date FDA Received | 12/27/2017 |
Supplement Dates Manufacturer Received | 12/01/2017
|
Supplement Dates FDA Received | 08/13/2018
|
Was Device Evaluated by Manufacturer? |
Yes
|
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Reuse
|
Patient Sequence Number | 1 |
|
|