FDA Adverse Event Malfunction Summary report: N

INTELLIVUE MX40 802.11A/B/G

MDR report key: 11364907 · Received February 23, 2021

Report

Report Number
1218950-2021-00884
Event Type
Malfunction
Date Received
February 23, 2021
Report Date
February 2, 2021
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
DSI
PMA / PMN Number
K113125
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 0

H10: THE ACTUAL DEVICE WAS RETURNED TO PHILIPS BENCH WHERE THE TECHNICIAN FOUND THE AUDIO WAS WORKING. THERE WERE SPEAKER ALARM AND LOG MESSAGES. THE TECHNICIAN FOUND THE SOUND WAS DISTORTED DUE TO WATER INTRUSION. WATER DAMAGE IS KNOWN TO BE CAUSED BY IMPROPER CLEANING/DISINFECTION OF THE MX40/MX4J PMW AND/OR USE OF UNAPPROVED CLEANING AND DISINFECTING AGENTS. SUBMISSION OF A REPORT DOES NOT CONSTITUTE AN ADMISSION THAT MEDICAL PERSONNEL, USER FACILITY, IMPORTER, DISTRIBUTOR, MANUFACTURER, OR PRODUCT CAUSED OR CONTRIBUTED TO THE EVENT.

Additional Manufacturer Narrative · 1

A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

THE CUSTOMER REPORTED A SPEAKER MALFUNCTION ON THE MX40 TELEMETRY DEVICE. IT IS UNKNOWN IF THE DEVICE HAD AUDIBLE SOUND. IT WAS REPORTED THE DEVICE WAS NOT IN CLINICAL USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
261540 INTELLIVUE MX40 802.11A/B/G PATIENT MONITOR DSI PHILIPS MEDICAL SYSTEMS 865352

Patients

Seq Age Sex Outcome Treatment
1