FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART XL+ DEFIBRILLATOR/MONITOR
MDR report key: 2943257
·
Received December 13, 2012
Report
- Report Number
- 1218950-2012-04058
- Event Type
- Malfunction
- Date Received
- December 13, 2012
- Report Date
- November 16, 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 A "DISABLED EQUIPMENT" ERROR MESSAGE AND THE DEVICE DOES NOT WORK. NO PATIENT INVOLVEMENT 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 |