FDA Adverse Event Other Summary report: N

HEARTSTART FR2+

MDR report key: 1611170 · Received February 12, 2010

Report

Report Number
3030677-2010-00015
Event Type
Other
Date Received
February 12, 2010
Date of Event
January 15, 2010
Report Date
February 12, 2010
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MKJ
PMA / PMN Number
06365
Removal / Correction Number
Z-00063-2010
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

DEVICE INTERNAL MEMORY REVIEWED. CONCLUSION - REPORT FILED BECAUSE, IT CANNOT BE CONCLUSIVELY STATED THAT REOCCURRENCE WOULD NOT LEAD TO DELAY OF THERAPY.

Description of Event or Problem · 1

PRODUCT WAS RETURNED AS PART OF RECALL Z-00063-2010. DURING INTERNAL EVALUATION WAS FOUND TO HAVE MEMORY CHIP FAILURE. NOTE: DATE OF EVENT NOTED CORRESPONDS WITH DATE OF INTERNAL EVALUATION. (B) (4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEARTSTART FR2+ AED MKJ PHILIPS MEDICAL SYSTEMS M3860A

Patients

Seq Age Sex Outcome Treatment
1