FDA Adverse Event Death Summary report: N

AVALON FM50 FETAL MONITOR

MDR report key: 1675636 · Received April 27, 2010

Report

Report Number
9610816-2010-00119
Event Type
Death
Date Received
April 27, 2010
Report Date
March 22, 2010
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
HGM
PMA / PMN Number
K071800
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AK, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE CUSTOMER REPORTED A FETAL DEATH. THERE IS NO INDICATION OF ANY DEVICE MALFUNCTION OR ANY FAILURE TO PERFORM AS INTENDED. PHILIPS IS IN THE PROCESS OF OBTAINING ADDITIONAL INFO CONCERNING THIS EVENT AND THE COMPLAINT IS STILL UNDER INVESTIGATION. A FINAL REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETED. (B) (4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED A FETAL DEATH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AVALON FM50 FETAL MONITOR HGM PHILIPS MEDICAL SYSTEMS M2705A

Patients

Seq Age Sex Outcome Treatment
1 Death