FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART MRX MONITOR/DEFIB
MDR report key: 11900848
·
Received May 28, 2021
Report
- Report Number
- 3030677-2021-11842
- Event Type
- Malfunction
- Date Received
- May 28, 2021
- Date of Event
- May 3, 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
- FR
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Description of Event or Problem · 1
IT WAS REPORTED TO PHILIPS THAT THE DEVICE WAS DROPPED AND DAMAGED THE PADDLES. THERE WAS NO PATIENT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 796991 | HEARTSTART MRX MONITOR/DEFIB | DEFIBRILLATOR | MKJ | PHILIPS NORTH AMERICA LLC | M3535A | 00884838000018 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |