FDA Adverse Event Death Summary report: N

PIC IX HARDWARE

MDR report key: 13488576 · Received February 8, 2022

Report

Report Number
1218950-2022-00111
Event Type
Death
Date Received
February 8, 2022
Date of Event
January 12, 2022
Manufacturer
PHILIPS NORTH AMERICA LLC
Product Code
MHX
PMA / PMN Number
K102495
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A FOLLOW UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE.

Additional Manufacturer Narrative · 0

A FOLLOW UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE.

Additional Manufacturer Narrative · 0

A PHILIPS REMOTE SERVICE ENGINEER (RSE) SPOKE WITH THE CUSTOMER. THE CALL WAS TRANSFERRED TO A PHILIPS REMOTE CLINICAL SPECIALIST (RCS). THE CUSTOMER INFORMED THAT RCS THAT WHAT THEY WOULD LIKE PHILIPS TO ASSIST WITH REVIEWING THE AUDIT LOG AND GENERAL REVIEW FULL DISCLOSURE WITH THEM AS WELL AS PULL OTHER LOGS. A PHILIPS FIELD SERVICE ENGINEER (FSE) WAS DISPATCHED AND RETRIEVED THE CLINICAL AUDIT LOGS, THE TECHNICAL LOG AND WAVE STRIPS. A PHILIPS CLINICAL SOLUTIONS IMPLEMENTATION CONSULTANT WENT ONSITE TO FURTHER REVIEW THE AUDIT LOG WITH THE CUSTOMER. THE LOGS WERE REVIEWED BY A PHILIPS CLINICAL PRODUCT SPECIALIST (CPS). IN ORDER FOR AN ALARM TO LOG IN THE PIC IX AUDIT LOG, THE ALARM HAS TO HAVE OCCURRED AT THE PIC IX. THE AUDIT LOG SHOWS THAT A YELLOW LOW SPO2 ALARMED AT 14:12:17 FOLLOWED BY A RED DESAT ALARM AT 14:12:28, WHICH WAS SILENCED AT 14:13:02 AND ENDED AT 14:15:05. AN ADDITIONAL RED DESAT ALARM WAS TRIGGERED AT 14:15:24 AND REMINDED AT 14:16:02. THE ALARM WAS SILENCED AT 14:16:54 AND ENDED THE ALARM. THERE WAS NO PRODUCT MALFUNCTION; THIS IS CONSIDERED A USER ISSUE. BASED ON PHILIPS¿ INVESTIGATION, THE LOGS INDICATE THAT THERE WERE INOPS FOR SPO2 AND A RED ALARM FOR DESAT THAT WERE SILENCED AT THE PIC IX SURVEILLANCE. NO FURTHER INVESTIGATION OR ACTION IS WARRANTED AT THIS TIME.

Description of Event or Problem · 0

THE CUSTOMER BIOMEDICAL ENGINEER REPORTED THAT AN MX40 PAIRED WITH AN MP5. A DESATURATION ALARM SOUNDED ON THE MP5 BUT NOT AT THE PATIENT INFORMATION CENTER IX (PIC IX ) OR AT THE OVERVIEW AS REPORTED BY STAFF. THE DEVICE WAS IN USE AT THE TIME OF EVENT, A DEATH WAS REPORTED.

Description of Event or Problem · 0

THE CUSTOMER BIOMEDICAL ENGINEER REPORTED THAT AN MX40 PAIRED WITH AN MP5. A DESATURATION ALARM SOUNDED ON THE MP5 BUT NOT AT THE PATIENT INFORMATION CENTER IX (PIC IX ) OR AT THE OVERVIEW AS REPORTED BY STAFF. THE DEVICE WAS IN USE AT THE TIME OF EVENT, A DEATH WAS REPORTED.

Description of Event or Problem · 0

THE CUSTOMER BIOMEDICAL ENGINEER REPORTED THAT AN MX40 PAIRED WITH AN MP5. A DESATURATION ALARM SOUNDED ON THE MP5 BUT NOT AT THE PATIENT INFORMATION CENTER IX (PIC IX ) OR AT THE OVERVIEW AS REPORTED BY STAFF. THE DEVICE WAS IN USE AT THE TIME OF EVENT, A DEATH WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
903638 PIC IX HARDWARE PIC IX HARDWARE MHX PHILIPS NORTH AMERICA LLC 866424

Patients

Seq Age Sex Outcome Treatment
1 72 YR Male Death