BEUDAMED
    FDA Adverse Event Death Summary report: N

    HEARTSTREAM FR2

    MDR report key: 2456373 · Received February 8, 2012

    Report

    Report Number
    3030677-2012-00053
    Event Type
    Death
    Date Received
    February 8, 2012
    Report Date
    February 2, 2012
    Manufacturer
    PHILIPS MEDICAL SYSTEMS (HTST)
    Product Code
    MKJ
    PMA / PMN Number
    003565
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    BE
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). DEVICE EVALUATION PENDING.

    Description of Event or Problem · 1

    AED DEPLOYED. SUBJECT WAS NOT RESUSCITATED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HEARTSTREAM FR2 MKJ PHILIPS MEDICAL SYSTEMS (HTST) M3841A

    Patients

    Seq Age Sex Outcome Treatment
    1 Death