FDA Adverse Event Malfunction Summary report: N

MP70 INTELLIVUE PATIENT MONITOR

MDR report key: 1852777 · Received September 27, 2010

Report

Report Number
9610816-2010-00453
Event Type
Malfunction
Date Received
September 27, 2010
Report Date
August 28, 2010
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
DSI
PMA / PMN Number
K021300
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4): THE CUSTOMER REPORTED THAT THERE WAS NO ALARM WHEN AN ECG WAVEFORM WENT FLATLINE FOR 5 SECONDS. NO PATIENT HARM WAS REPORTED. 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 THERE WAS NO ALARM WHEN AN ECG WAVEFORM WENT FLATLINE FOR 5 SECONDS. NO PATIENT HARM WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MP70 INTELLIVUE PATIENT MONITOR DSI PHILIPS MEDICAL SYSTEMS M8007A

Patients

Seq Age Sex Outcome Treatment
1