FDA Adverse Event
Malfunction
Summary report: N
HEART START XL
MDR report key: 2113606
·
Received May 24, 2011
Report
- Report Number
- 1218950-2011-01451
- Event Type
- Malfunction
- Date Received
- May 24, 2011
- Report Date
- April 25, 2011
- Manufacturer
- PHILIPS MEDICAL
- Product Code
- MKJ
- PMA / PMN Number
- K001725
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CH
- Reporter Occupation
- UNKNOWN
Narratives
Additional Manufacturer Narrative · 1
(B)(4). THE CUSTOMER REPORTED THE DEVICE WAS 'UNABLE TO RUN A SELF-TEST.' NO ADDITIONAL DETAIL WAS PROVIDED. 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 THE DEVICE WAS 'UNABLE TO RUN A SELF-TEST.' NO ADDITIONAL DETAIL WAS PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | HEART START XL | MKJ | PHILIPS MEDICAL | M4735A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |