FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART FRX DEFIBRILLATOR
MDR report key: 12075579
·
Received June 28, 2021
Report
- Report Number
- 3030677-2021-12530
- Event Type
- Malfunction
- Date Received
- June 28, 2021
- Manufacturer
- PHILIPS NORTH AMERICA LLC
- Product Code
- MKJ
- UDI-DI
- 00884838080768
- PMA / PMN Number
- P180028
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- OTHER
- Health Professional
- N
Narratives
Description of Event or Problem · 1
IT HAS BEEN REPORTED THAT THE DEVICE IS FAILING SELF-TEST.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 970682 | HEARTSTART FRX DEFIBRILLATOR | AED | MKJ | PHILIPS NORTH AMERICA LLC | 861304 | 00884838080768 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |