BEUDAMED
    FDA Adverse Event Death Summary report: N

    FR2

    MDR report key: 1880141 · Received October 20, 2010

    Report

    Report Number
    3030677-2010-00340
    Event Type
    Death
    Date Received
    October 20, 2010
    Date of Event
    October 11, 2010
    Report Date
    October 20, 2010
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    MKJ
    PMA / PMN Number
    03565
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    ASSESSMENT OF DEVICE PENDING.

    Description of Event or Problem · 1

    AED DEPLOYED TO ATTEMPT RESUSCITATION. SUBJECT WAS NOT RESUSCITATED. (DEVICE # 2) (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FR2 AED MKJ PHILIPS MEDICAL SYSTEMS M3860A-ABU

    Patients

    Seq Age Sex Outcome Treatment
    1 Death