FDA Adverse Event Malfunction Summary report: N

HEART START XL

MDR report key: 17982275 · Received October 22, 2023

Report

Report Number
3030677-2023-04200
Event Type
Malfunction
Date Received
October 22, 2023
Date of Event
October 6, 2023
Manufacturer
PHILIPS NORTH AMERICA LLC
Product Code
MKJ
PMA / PMN Number
K021453
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS BASED ON INFORMATION PROVIDED BY PHILIPS SERVICE REPRESENTATIVE AND HAS BEEN INVESTIGATED BY THE PHILIPS COMPLAINT HANDLING TEAM. PHILIPS RECEIVED A COMPLAINT ON THE HEARTSTART XL. THE SERVICE TECHNICIAN DOING A PREVENTIVE MAINTENANCE FOUND THE DEVICE FAILING TESTING DUE TO A DEPLETED BATTERY. THERE WAS NO PATIENT INVOLVEMENT. THE SERVICE TECHNICIAN DOING A PREVENTIVE MAINTENANCE FOUND THE DEVICE FAILING TESTING DUE TO A DEPLETED BATTERY. THE DEVICE NEEDS A BATTERY. HOWEVER, SINCE THE DEVICE IS END-OF-LIFE (EOL) SINCE 31DEC2017, PARTS THROUGH PHILIPS ARE NOT AVAILABLE. BASED ON THE INFORMATION AVAILABLE AND THE TESTING CONDUCTED, THE CAUSE OF THE REPORTED PROBLEM WAS A DEPLETED BATTERY. THE REPORTED PROBLEM WAS CONFIRMED. THE CUSTOMER IS SEEKING A REPLACEMENT BATTERY. ONCE THE BATTERY IS REPLACED THE DEVICE WILL BE FULLY OPERATIONAL. THE INVESTIGATION CONCLUDES THAT NO FURTHER ACTION IS REQUIRED AT THIS TIME.

Description of Event or Problem · 0

IT WAS REPORTED TO PHILIPS THAT THE DEVICE FAILED TESTING DUE TO A DEPLETED BATTERY. THERE WAS NO PATIENT INVOLVEMENT.

Description of Event or Problem · 0

IT WAS REPORTED TO PHILIPS THAT THE DEVICE BATTERY IS INSUFFICIENT. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1272315 HEART START XL DEFIBRILLATOR MKJ PHILIPS NORTH AMERICA LLC M4735A

Patients

Seq Age Sex Outcome Treatment
1 Unknown