FDA Adverse Event Death Summary report: N

HEARTSTART FRX

MDR report key: 2854066 · Received November 28, 2012

Report

Report Number
3030677-2012-01533
Event Type
Death
Date Received
November 28, 2012
Report Date
November 16, 2012
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MKJ
PMA / PMN Number
050004
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CURRENTLY PENDING EVALUATION OF THE INCIDENT.

Description of Event or Problem · 1

DURING DEPLOYMENT, THE SUBJECT WAS NOT RESUSCITATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEARTSTART FRX MKJ PHILIPS MEDICAL SYSTEMS 861304

Patients

Seq Age Sex Outcome Treatment
1 Death