FDA Adverse Event Death Summary report: N

INTELLIVUE INFORMATION CENTER

MDR report key: 1655769 · Received April 7, 2010

Report

Report Number
1218950-2010-00458
Event Type
Death
Date Received
April 7, 2010
Report Date
March 31, 2010
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MHX
PMA / PMN Number
K081983
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SN
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE CUSTOMER REPORTED THAT NO ALARMS WERE PROVIDED AT THE BEDSIDE AND CENTRAL STATION FOR A PATIENT DEATH. POST INCIDENT TESTING OF ALL INVOLVED PHILIPS DEVICES SHOWED THAT THEY WERE ALL PERFORMING AS INTENDED AND SPECIFIED. ALARMS WERE SHOWN TO HAVE OCCURRED THROUGHOUT THE TIME IN QUESTION. PHILIPS IS IN THE PROCESS OF OBTAINING ADDITIONAL INFORMATION REGARDING THIS INCIDENT AND THE COMPLAINT IS STILL UNDER INVESTIGATION. A FINAL REPORT WILL BE PROVIDED ONCE THE INVESTIGATION IS COMPLETED. (B) (4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT NO ALARMS WERE PROVIDED AT THE BEDSIDE AND CENTRAL STATION FOR A PATIENT DEATH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTELLIVUE INFORMATION CENTER MHX PHILIPS MEDICAL SYSTEMS 862067 (M3150B)

Patients

Seq Age Sex Outcome Treatment
1 70 YR Death