FDA Adverse Event Malfunction Summary report: N

INTERNAL PADDLES OPTION FOR DEFIBRILLATOR/MONITOR

MDR report key: 1882443 · Received October 20, 2010

Report

Report Number
1218950-2010-01979
Event Type
Malfunction
Date Received
October 20, 2010
Report Date
September 21, 2010
Manufacturer
PHILIPS HEALTHCARE
Product Code
MKJ
PMA / PMN Number
K031187
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 THE INTERNAL PADDLES FAILED THE OHMS TEST AND WERE NOT DETECTED WHEN ATTACHED TO DEFIBRILLATOR. THE INTERNAL PADDLES WERE REPLACED TO RESOLVE THE ISSUE.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE INTERNAL PADDLES FAILED THE OHMS TEST AND WERE NOT DETECTED WHEN ATTACHED TO DEFIBRILLATOR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTERNAL PADDLES OPTION FOR DEFIBRILLATOR/MONITOR MKJ PHILIPS HEALTHCARE M4742A DATE CODE 1/10

Patients

Seq Age Sex Outcome Treatment
1