FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART MRX -EMS DEFIBRILLATOR
MDR report key: 2050446
·
Received April 5, 2011
Report
- Report Number
- 1218950-2011-00912
- Event Type
- Malfunction
- Date Received
- April 5, 2011
- Report Date
- March 9, 2011
- Manufacturer
- PHILIPS HEALTHCARE
- Product Code
- MKJ
- PMA / PMN Number
- K031187
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- UNKNOWN
Narratives
Additional Manufacturer Narrative · 1
(B)(4): THE CUSTOMER REPORTED UNABLE TO ACQUIRE 12 LEAD ECG DURING USE ON A PT. THE USER SWITCHED TO A BACKUP DEVICE AND THERE WAS NO REPORTED ADVERSE PT IMPACT. 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 UNABLE TO ACQUIRE 12 LEAD ECG DURING USE ON A PT. THE USER SWITCHED TO A BACKUP DEVICE AND THERE WAS NO REPORTED ADVERSE PT IMPACT.
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 |