Recall Reply Form - DVI Cables - Spacelabs Healthcare

Please complete and submit the form below to acknowledge the following:

You have received and understand the referenced Medical Device Notification.
Your organization has informed appropriate staff, has taken and will take appropriate action in accordance with this this Notification.

Reference:

3010157426-08112025-001-C, Xprezzon Display Cable Radiated Emissions FCA

Confirmation *
By checking this box, I acknowledge the receipt and understanding of the associated medical device notice, confirm that I will carry out the actions outlined, and that I am authorized to acknowledge this notice on behalf of the organization listed below.By checking this box, I acknowledge the receipt and understanding of the associated medical device notice, confirm that we at the site listed below do not have any of the affected products outlined in the referenced medical device notice, and that I am authorized to acknowledge this notice on behalf of the organization listed below.

Replacement cables required:

Display Cable Length	Single Display Cable Quantity	Dual Display Cable Quantity
12ft
6ft
20in

Note: If you use a dual display configuration, you must use at least one dual display compatible cable.

Shipping Address for Cables

Organization Name*

Department/Unit*

Organization Address*

City*

State/Province/Region*

Zip Code/Postal Code*

Country*

Contact Name*

Contact Job Title or Function*

Contact Email*

Contact Telephone

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