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MAUDE Adverse Event Report: HOLOGIC, INC SELENIA DIMENSIONS MAMMOGRAPHY SYSTEMS, 3D
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HOLOGIC, INC SELENIA DIMENSIONS MAMMOGRAPHY SYSTEMS, 3D
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Model Number
SDM-00001-3D
Medical Device Problem Code
Unintended System Motion (1430)
Health Effect - Clinical Code
No Known Impact Or Consequence To Patient (2692)
Date of Event
07/13/2018
Type of Reportable Event
Malfunction
Event or Problem Description
It was reported that when the technologist was positioning the c-arm, it was passing the intended position and continued rotating.No injury reported.A field engineer was dispatched to the site and a full reboot of the system was completed.
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Brand Name
SELENIA DIMENSIONS MAMMOGRAPHY SYSTEMS, 3D
Common Device Name
MAMMOGRAPHY SYSTEM
Manufacturer
(Section D)
HOLOGIC, INC
36 & 37 apple ridge road
danbury CT 06810
MDR Report Key
7772196
Report Number
1220984-2018-00128
Device Sequence Number
1011612
Product Code
OTE
UDI-Device Identifier
15420045505582
UDI-Public
15420045505582
Combination Product (Y/N)
N
Initial Reporter State
WA
Initial Reporter Country
US
PMA/510(K) Number
P080003
Number of Events Summarized
1
Summary Report (Y/N)
N
Reporter Type
Manufacturer
Report Source
health professional,user faci
Initial Reporter Occupation
Other Health Care Professional
Type of Report
Initial
Report Date
(Section B)
07/13/2018
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 Number
SDM-00001-3D
Was Device Available for Evaluation?
Yes
Type of Report(Section G)
Thirty-Day
Initial Date Received by Manufacturer
07/13/2018
Initial Report FDA Received Date
08/10/2018
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number
1
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