FDA Adverse Event Malfunction Summary report: N

HEARTSTART MRX - EMS DEFIBRILLATOR

MDR report key: 2082703 · Received April 28, 2011

Report

Report Number
1218950-2011-01192
Event Type
Malfunction
Date Received
April 28, 2011
Report Date
April 5, 2011
Manufacturer
PHILIPS HEALTHCARE
Product Code
MKJ
PMA / PMN Number
K031187
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE CUSTOMER REPORTED THAT DURING A PREVENTIVE MAINTENANCE TEST, THE DEFIBRILLATOR WAS TESTED AND FOUND TO HAVE A HIGH PACER OUTPUT. THIS COMPLAINT IS STILL BEING INVESTIGATED. A FOLLOW-UP REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT DURING A PREVENTIVE MAINTENANCE TEST, THE DEFIBRILLATOR WAS TESTED AND FOUND TO HAVE A HIGH PACER OUTPUT.

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