INTEGRIS CV (CESAR-POWERPACK-VISUB-NICOL) 722030

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-10-23 for INTEGRIS CV (CESAR-POWERPACK-VISUB-NICOL) 722030 manufactured by Philips Healthcare.

Event Text Entries

[124984663] When the investigation has been completed phillips will inform the fda.
Patient Sequence No: 1, Text Type: N, H10


[124984664] Philips has received through (b)(6) a report submitted by a customer. In this report, the customer reported that? During a revision operation of an implantable cardioverter defibrillator (icd), no filming with the system was possible (foot switch does not work as on friday of the previous week for filming). The same problem had occurred on friday of the previous week; hospital medical technology was informed, was on site and stated that the problem had been solved. During the procedure, after 10 minutes of fluoroscopy with the icd already exposed, no fluoroscopy was possible. A complete shutdown of the system was done and then at least fluoroscopy was possible again. Significant delay of the operation time (thus increasing risk of infection). The affected system (philips integris cv) dates from 1996 and is in end-of-service status. As a result, the manufacturer can no longer guarantee the availability of spare parts. So far, however, all malfunctions could still be repaired. According to the original reinvestment planning, the device was to be replaced this year as part of the ppp conversions. Due to the delays in construction that have occurred in the meantime, the device is currently still in operation. From our point of view, the device should not and can no longer be operated?. Because of the allegation on potential harm this report is being submitted. Philips has initiated an investigation of this complaint.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3003768277-2018-00080
MDR Report Key7995600
Date Received2018-10-23
Date of Report2018-09-25
Date Mfgr Received2018-09-25
Device Manufacturer Date2005-05-02
Date Added to Maude2018-10-23
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. DUSTY LEPPERT
Manufacturer StreetVEENPLUIS 4-6 P.O. BOX 10.000
Manufacturer CityBEST 5680DA
Manufacturer CountryNL
Manufacturer Postal5680 DA
Manufacturer G1PHILIPS MEDICAL SYSTEMS
Manufacturer Street3000 MINUTEMAN ROAD
Manufacturer CityANDOVER MA 01810
Manufacturer CountryUS
Manufacturer Postal Code01810
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameINTEGRIS CV (CESAR-POWERPACK-VISUB-NICOL)
Generic NameSYSTEM, X-RAY, ANGIOGRAPHIC
Product CodeIZI
Date Received2018-10-23
Model Number722030
Catalog Number722030
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerPHILIPS HEALTHCARE
Manufacturer AddressVEENPLUIS 4-6 P.O. BOX 10.000 BEST 5680DA NL 5680 DA


Patients

Patient NumberTreatmentOutcomeDate
10 2018-10-23

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