BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTART MRX MONITOR/DEFIB

    MDR report key: 11828775 · Received May 14, 2021

    Report

    Report Number
    3030677-2021-11501
    Event Type
    Malfunction
    Date Received
    May 14, 2021
    Date of Event
    April 20, 2021
    Manufacturer
    PHILIPS NORTH AMERICA LLC
    Product Code
    MKJ
    UDI-DI
    00884838000018
    PMA / PMN Number
    K031187
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE DEVICE FAILED TO DELIVER CHARGE/SHOCK. THERE WAS REPORTEDLY NO PATIENT INVOLVEMENT. THE DEVICE WAS SENT TO AUTHORIZED FACILITY FOR THE BENCH REPAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    720443 HEARTSTART MRX MONITOR/DEFIB DEFIBRILLATOR MKJ PHILIPS NORTH AMERICA LLC M3535A 00884838000018

    Patients

    Seq Age Sex Outcome Treatment
    1