BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEART START XL

    MDR report key: 1961276 · Received December 21, 2010

    Report

    Report Number
    1218950-2010-02683
    Event Type
    Malfunction
    Date Received
    December 21, 2010
    Report Date
    November 30, 2010
    Manufacturer
    PHILIPS HEALTHCARE
    Product Code
    MKJ
    PMA / PMN Number
    K001725
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4): THE CUSTOMER REPORTED PADS/PADDLES ECG WAS NOT WORKING. THERE WAS NO REPORT OF PT INVOLVEMENT. THE PHILIPS CUSTOMER REPAIR CTR (CRC) EVALUATED THE DEVICE, CONFIRMED THE FAILURE, AND RESOLVED THE FAILURE BY REPLACING THE POWER PCA.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED PADS/PADDLES ECG WAS NOT WORKING. THERE WAS NO REPORT OF PT INVOLVEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HEART START XL MKJ PHILIPS HEALTHCARE M4735A

    Patients

    Seq Age Sex Outcome Treatment
    1