BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTART MRX - EMS DEFIBRILLATOR

    MDR report key: 2121297 · Received May 4, 2011

    Report

    Report Number
    1218950-2011-01270
    Event Type
    Malfunction
    Date Received
    May 4, 2011
    Report Date
    April 8, 2011
    Manufacturer
    PHILIPS HEALTHCARE
    Product Code
    MKJ
    PMA / PMN Number
    K031187
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). THE CUSTOMER REPORTED THAT WHEN RUNNING THE DEFIBRILLATION CHARGE CHECK THEY HEARD A CHIRP AND THEN SAW A RED X. THERE WAS NO REPORTED PT INVOLVEMENT. PHILIPS EVALUATED THE DEVICE AND CONFIRMED THE PROBLEM. PHILIPS FOUND THE POWER WIRE DISCONNECTED FROM THERAPY PCA TO POWER PCA. IT WAS RECONNECTED AND RETESTED. THE DEVICE PASSED ALL TESTS AND WAS PUT BACK INTO SERVICE.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT WHEN RUNNING THE DEFIBRILLATION CHARGE CHECK THEY HEARD A CHIRP AND THEN SAW A RED X. THERE WAS NO REPORTED PT INVOLVEMENT.

    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