FDA Adverse Event Malfunction Summary report: N

INTELLIVUE MP2

MDR report key: 2243782 · Received July 29, 2011

Report

Report Number
9610816-2011-00446
Event Type
Malfunction
Date Received
July 29, 2011
Report Date
July 8, 2011
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MHX
PMA / PMN Number
K040357
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE CUSTOMER REPORTED THAT THIS INTELLIVUE X2 DEVICE SUFFERED A FALL, AND AS A RESULT OF THE DROP, THE HOUSING WAS BROKEN. NO PT HARM WAS REPORTED. THE AVAILABLE INFO DOES NOT SUPPORT THAT THERE WAS A MALFUNCTION OF THE DEVICE BUT IT ALSO DOES NOT IDENTIFY A USER MISUNDERSTANDING/MISUSE AS THE CAUSE OF THIS REPORTED FAILURE TO FUNCTION AS EXPECTED. THERE WAS NO MENTION OF A DEFECTIVE MOUNTING SOLUTION, OR ANY OTHER MECHANICAL DEFECT CONTRIBUTING TO THE DROP, WAS REPORTED. IT WAS NOT REPORTED THAT THIS WAS AN UNEXPECTED DROP. PHILIPS IS IN THE PROCESS OF OBTAINING ADDITIONAL INFO REGARDING THIS INCIDENT AND THE COMPLAINT IS STILL UNDER INVESTIGATION. A FINAL REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THIS INTELLIVUE X2 DEVICE SUFFERED A FALL, AND AS A RESULT OF THE DROP, THE HOUSING WAS BROKEN. NO PT HARM WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTELLIVUE MP2 MHX PHILIPS MEDICAL SYSTEMS M8102A

Patients

Seq Age Sex Outcome Treatment
1