FDA Adverse Event Malfunction Summary report: N

COMPACT MONITOR DISPLAY

MDR report key: 1811173 · Received August 13, 2010

Report

Report Number
9610816-2010-00306
Event Type
Malfunction
Date Received
August 13, 2010
Report Date
July 5, 2010
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MHX
PMA / PMN Number
K001664
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE CUSTOMER REPORTED THAT AN M3046A MONITOR FELL AND WAS DAMAGED. NO PATIENT HARM WAS REPORTED AS A RESULT OF THIS INCIDENT. PHILIPS IS IN THE PROCESS OF OBTAINING ADDITIONAL INFORMATION CONCERNING THIS EVENT AND THE COMPLAINT IS STILL UNDER INVESTIGATION. A FINAL REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT AN (B)(4) MONITOR FELL AND WAS DAMAGED. NO PATIENT HARM WAS REPORTED AS A RESULT OF THIS INCIDENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COMPACT MONITOR DISPLAY MHX, DRT MHX PHILIPS MEDICAL SYSTEMS M3046A

Patients

Seq Age Sex Outcome Treatment
1