FDA Adverse Event
Malfunction
Summary report: N
MX40 1.4 GHZ SMART HOPPING
MDR report key: 11611913
·
Received April 4, 2021
Report
- Report Number
- 1218950-2021-10280
- Event Type
- Malfunction
- Date Received
- April 4, 2021
- Date of Event
- March 10, 2021
- Manufacturer
- PHILIPS NORTH AMERICA LLC
- Product Code
- DSI
- UDI-DI
- 00884838082236
- PMA / PMN Number
- K113125
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
DURING PRODUCT EVALUATION, THE BENCH REPAIR TECHNICIAN FOUND NO AUDIO/NO SOUND ON THE MX40 TELEMETRY DEVICE. THE DEVICE WAS NOT IN USE ON A PATIENT AT THE TIME OF THE EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 509301 | MX40 1.4 GHZ SMART HOPPING | MX40 1.4 GHZ SMART HOPPING | DSI | PHILIPS NORTH AMERICA LLC | 865350 | 00884838082236 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |