FDA Adverse Event Malfunction Summary report: N

PIC 50

MDR report key: 2022503 · Received February 15, 2011

Report

Report Number
3023750-2011-01027
Event Type
Malfunction
Date Received
February 15, 2011
Report Date
January 25, 2011
Manufacturer
WELCH ALLYN PROTOCOL, INC
Product Code
MKJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN RECEIVED FOR EVALUATION AND THIS COMPLAINT IS STILL UNDER INVESTIGATION.

Description of Event or Problem · 1

COMPLAINANT ALLEGED THAT DURING A ROUTINE SHIFT CHECK BY A CLINICIAN, THE DEVICE WOULD NOT POWER UP. COMPLAINANT INDICATED THAT THERE WAS NO PATIENT INVOLVEMENT IN THE REPORTED MALFUNCTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PIC 50 AUTOMATED EXTERNAL DEFIB MKJ WELCH ALLYN PROTOCOL, INC PIC50 NA

Patients

Seq Age Sex Outcome Treatment
1 NA