BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEART START XL

    MDR report key: 2140586 · Received June 16, 2011

    Report

    Report Number
    1218950-2011-01725
    Event Type
    Malfunction
    Date Received
    June 16, 2011
    Report Date
    May 18, 2011
    Manufacturer
    PHILIPS HEALTHCARE
    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 THAT THE DISPLAY ON THE DEVICE WAS BLANK. THE DEVICE WAS EVALUATED BY A THIRD PARTY SERVICE PROVIDER. THE OPTICAL SWITCH ASSEMBLY WAS REPLACED TO RESOLVE THE ISSUE. BASED ON THE REPAIR INFORMATION FOR THIS EVENT, THE REPORTED SYMPTOM IS CONSISTENT WITH A FAILURE TO POWER UP.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE DISPLAY ON THE DEVICE WAS BLANK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HEART START XL MKJ PHILIPS HEALTHCARE M4735A

    Patients

    Seq Age Sex Outcome Treatment
    1