FDA Adverse Event Malfunction Summary report: N

STRESSVUE

MDR report key: 2002689 · Received February 9, 2011

Report

Report Number
1218950-2011-00354
Event Type
Malfunction
Date Received
February 9, 2011
Report Date
January 11, 2011
Manufacturer
PHILIPS HEALTHCARE
Product Code
DPS
PMA / PMN Number
K022618
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE CUSTOMER REPORTED SEVERE ARTIFACTON 12 LEAD ECG. ST SEGMENT MAYBE INCORRECTLY AMPLIFIED. PHILIPS WAS UNABLE TO CONFIRM THE CUSTOMERS REPORTED PROBLEM. THERE WAS NO TROUBLE FOUND, NO REPAIR WAS DONE OR NECESSARY. THE DEVICE IS WORKING AS INTENDED. NO CAUSE COULD BE DETERMINED.

Description of Event or Problem · 1

THE CUSTOMER REPORTED SEVERE ARTIFACTON 12 LEAD ECG.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STRESSVUE DPS PHILIPS HEALTHCARE 860295

Patients

Seq Age Sex Outcome Treatment
1