BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTART MRX - EMS DEFIBRILLATOR

    MDR report key: 1983702 · Received February 3, 2011

    Report

    Report Number
    1218950-2011-00310
    Event Type
    Malfunction
    Date Received
    February 3, 2011
    Report Date
    January 6, 2011
    Manufacturer
    PHILIPS HEALTHCARE
    Product Code
    MKJ
    PMA / PMN Number
    K031187
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    BR
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). THE CUSTOMER REPORTED THAT THE UNIT HAD A RED X AND WAS BEEPING. ON (B)(6) 2011 NEW INFO WAS RECEIVED FROM THE LOCAL REPAIR BENCH THAT MAKES THIS EVENT REPORTABLE. THE UNIT WAS EVALUATED LOCALLY AND IT WAS DETERMINED THAT THE UNIT COULD NOT DELIVER A SHOCK. THIS COMPLAINT IS STILL BEING INVESTIGATED. A F/U REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE UNIT HAD A RED X AND WAS BEEPING. ON (B)(6) 2011 NEW INFO WAS RECEIVED FROM THE LOCAL REPAIR BENCH THAT MAKES THIS EVENT REPORTABLE. THE UNIT WAS EVALUATED LOCALLY AND IT WAS DETERMINED THAT THE UNIT COULD NOT DELIVER A SHOCK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HEARTSTART MRX - EMS DEFIBRILLATOR MKJ PHILIPS HEALTHCARE M3536A

    Patients

    Seq Age Sex Outcome Treatment
    1