FDA Adverse Event Malfunction Summary report: N

HEARTSTART XL + DEFIBRILLATOR/MONITOR

MDR report key: 2914193 · Received December 7, 2012

Report

Report Number
1218950-2012-04041
Event Type
Malfunction
Date Received
December 7, 2012
Report Date
November 14, 2012
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MKJ
PMA / PMN Number
K110825
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THIS COMPLAINT IS STILL BEING INVESTIGATED. A FOLLOW-UP REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem · 1

THE CUSTOMER REPORTED GETTING A RED X/NOT READY FOR USE INDICATOR AND A MESSAGE THAT SAID, "CLINICAL MODE NOT AVAILABLE DUE TO DISABLED EQUIPMENT. RUN OPCHECK" DURING PT TRANSFER TO A DIFFERENT HOSPITAL UNIT. NO ADVERSE PT IMPACT WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEARTSTART XL + DEFIBRILLATOR/MONITOR MKJ PHILIPS MEDICAL SYSTEMS 861290

Patients

Seq Age Sex Outcome Treatment
1