FDA Adverse Event Death Summary report: N

MP20 INTELLIVUE PATIENT MONITOR

MDR report key: 1689100 · Received May 10, 2010

Report

Report Number
9610816-2010-00142
Event Type
Death
Date Received
May 10, 2010
Report Date
May 6, 2010
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MHX
PMA / PMN Number
K030038
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE CUSTOMER REPORTED THAT A PATIENT DEATH OCCURRED AND THE NURSES WERE UNCERTAIN IF THE MONITOR WAS SWITCHED OFF. BASED ON THE IMMEDIATE AVAILABLE INFORMATION, THE HOSPITAL'S BIOMED TESTED THE ALARMS WITH A SIMULATOR AND FOUND NO FAULTS. PHILIPS IS IN THE PROCESS OF OBTAINING ADDITIONAL INFORMATION REGARDING THIS INCIDENT AND THE COMPLAINT REMAINS UNDER INVESTIGATION. A FINAL REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETED. (B) (4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT A PATIENT DEATH OCCURRED, AND THE NURSES WERE UNCERTAIN IF THE MONITOR WAS SWITCHED OFF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MP20 INTELLIVUE PATIENT MONITOR MHX PHILIPS MEDICAL SYSTEMS

Patients

Seq Age Sex Outcome Treatment
1 Death