MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2019-08-19 for MULTIX IMPACT 11020788 manufactured by Siemens Shanghai Medical Equipment Ltd.
| Report Number | 3003202425-2019-91427 |
| MDR Report Key | 8905630 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2019-08-19 |
| Date of Report | 2019-07-25 |
| Date of Event | 2019-07-24 |
| Date Mfgr Received | 2019-08-23 |
| Device Manufacturer Date | 2019-06-12 |
| Date Added to Maude | 2019-08-19 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | ANASTASIA SOKOLOVA |
| Manufacturer Street | 40 LIBERTY BLVD, MC 65-1A |
| Manufacturer City | MALVERN PA 19355 |
| Manufacturer Country | US |
| Manufacturer Postal | 19355 |
| Manufacturer Phone | 6104486478 |
| Manufacturer G1 | SIEMENS SHANGHAI MEDICAL EQUIPMENT LTD |
| Manufacturer Street | 278 ZHOU ZHU ROAD |
| Manufacturer City | SHANGHAI, 201318 |
| Manufacturer Country | CH |
| Manufacturer Postal Code | 201318 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | MULTIX IMPACT |
| Generic Name | STATIONARY X-RAY SYSTEM |
| Product Code | KPR |
| Date Received | 2019-08-19 |
| Model Number | 11020788 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SIEMENS SHANGHAI MEDICAL EQUIPMENT LTD |
| Manufacturer Address | 278 ZHOU ZHU ROAD SHANGHAI, 201318 CH 201318 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2019-08-19 |