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