FDA Adverse Event Malfunction Summary report: N

HEARTSTART SLA BATTERY

MDR report key: 2862292 · Received November 5, 2012

Report

Report Number
1218950-2012-03689
Event Type
Malfunction
Date Received
November 5, 2012
Report Date
September 18, 2012
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
DQA
PMA / PMN Number
K001725
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

(B)(4): THE CUSTOMER REPORTED A BAD BATTERY AND THE DEVICE DID NOT POWER UP. THERE WAS NO PATIENT INVOLVEMENT. THE CUSTOMER EVALUATED THE BATTERY AND DETERMINED IT WAS FAULTY. THE CUSTOMER WAS PROVIDED INFORMATION PER (B)(6). THIS A MALFUNCTION OF THE BATTERY WHERE THE DEVICE FAILED TO POWER UP.

Description of Event or Problem · 1

THE CUSTOMER REPORTED A BAD BATTERY AND THE DEVICE DID NOT POWER UP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEARTSTART SLA BATTERY DQA, MKJ, LDD, DRO DQA PHILIPS MEDICAL SYSTEMS M3516A R-2011-12

Patients

Seq Age Sex Outcome Treatment
1