FDA Adverse Event Malfunction Summary report: N

HEARTSTART MRX

MDR report key: 2142592 · Received June 21, 2011

Report

Report Number
1218950-2011-01763
Event Type
Malfunction
Date Received
June 21, 2011
Report Date
May 23, 2011
Manufacturer
PHILIPS HEALTHCARE - ANDOVER
Product Code
MKJ
PMA / PMN Number
K031187
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE CUSTOMER REPORTED THAT THE DEVICE WOULD LOCK UP (STOP OPERATION) DURING THE CHARGE TEST SEGMENT OF THE OPERATIONAL CHECK. THERE WAS NO REPORT OF PT INVOLVEMENT OR NEGATIVE PT IMPACT. PHILIPS EVALUATED THE DEVICE AND CONFIRMED THE MALFUNCTION. THE MALFUNCTION WAS RESOLVED BY REPLACEMENT OF THE PROCESSOR PCA AND RELOADING THE SOFTWARE.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE DEVICE WOULD LOCK UP (STOP OPERATION) DURING THE CHARGE TEST SEGMENT OF THE OPERATIONAL CHECK. THERE WAS NO REPORT OF PT INVOLVEMENT OR NEGATIVE PT IMPACT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEARTSTART MRX MKJ PHILIPS HEALTHCARE - ANDOVER M3535A

Patients

Seq Age Sex Outcome Treatment
1