BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AC POWER MODULE

    MDR report key: 2072769 · Received March 31, 2011

    Report

    Report Number
    1218950-2011-00870
    Event Type
    Malfunction
    Date Received
    March 31, 2011
    Report Date
    March 4, 2011
    Manufacturer
    PHILIPS HEALTHCARE
    Product Code
    MKJ
    PMA / PMN Number
    K031187
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4): THE CUSTOMER REPORTED THAT THE UNIT FAILED TO CHARGE THE BATTERY. THERE WAS NO REPORT OF PT INVOLVEMENT. PHILIPS CUSTOMER CARE CENTER AND THE CUSTOMER DETERMINED THAT THE A POWER MODULE HAD FAILED. THE CUSTOMER WAS SENT A NEW AC POWER MODULE WHICH RESOLVED THE FAILURE.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE UNIT FAILED TO CHARGE THE BATTERY. THERE WAS NO REPORT OF PT INVOLVEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AC POWER MODULE MKJ PHILIPS HEALTHCARE M3539A

    Patients

    Seq Age Sex Outcome Treatment
    1