BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEART START XL

    MDR report key: 2170824 · Received June 22, 2011

    Report

    Report Number
    1218950-2011-01798
    Event Type
    Malfunction
    Date Received
    June 22, 2011
    Report Date
    May 25, 2011
    Manufacturer
    PHILIPS HEALTHCARE - ANDOVER
    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 HAVING NO DISPLAY ON THE SCREEN. THERE WAS NO PATIENT INVOLVEMENT. THE DEVICE WAS EVALUATED BY A PHILIPS FIELD SERVICE ENGINEER. THE SYMPTOM WAS CLARIFIED AS A FAILURE TO POWER UP. MULTIPLE PARTS WERE REPLACED TO RESOLVE THE ISSUE, THEREFORE WE ARE UNABLE TO DETERMINE THE EXACT CAUSE OF THIS MALFUNCTION.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED HAVING NO DISPLAY ON THE SCREEN. THERE WAS NO PATIENT INVOLVEMENT.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1