FDA Adverse Event Malfunction Summary report: N

HEARTSTART MRX - EMS DEFIBRILLATOR

MDR report key: 2896413 · Received November 20, 2012

Report

Report Number
1218950-2012-03860
Event Type
Malfunction
Date Received
November 20, 2012
Report Date
October 26, 2012
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MKJ
PMA / PMN Number
K031187
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE CUSTOMER REPORTED THAT THE MONITOR CAME ON WITH SWITCH IN OFF POSITION, SYNC CAME ON WITHOUT BEING TURNED ON. THERE IS NO REPORTED PT INVOLVEMENT. THE PHILIPS REPAIR BENCH EVALUATED THE DEVICE. NO TROUBLE WAS FOUND. NO REPAIRS WERE NEEDED RELATED TO THIS COMPLAINT. THE DEVICE PASSED ALL PERFORMANCE ASSURANCE TESTING AND WAS RETURNED TO THE CUSTOMER. PHILIPS WAS NOT ABLE TO CONFIRM THE REPORTED MALFUNCTION. NO CAUSE CAN BE DETERMINED.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE MONITOR CAME ON WITH SWITCH IN OFF POSITION, SYNC CAME ON WITHOUT BEING TURNED ON.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEARTSTART MRX - EMS DEFIBRILLATOR MKJ PHILIPS MEDICAL SYSTEMS M3536A

Patients

Seq Age Sex Outcome Treatment
1