BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    INTELLIVUE

    MDR report key: 3032113 · Received March 28, 2013

    Report

    Report Number
    3032113
    Event Type
    Malfunction
    Date Received
    March 28, 2013
    Date of Event
    March 25, 2013
    Report Date
    March 28, 2013
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    DQA
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ, US
    Reporter Occupation
    RISK MANAGER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    127574 INTELLIVUE MONITOR, PHYSGIOLOGIC DQA PHILIPS MEDICAL SYSTEMS MP50 *

    Patients

    Seq Age Sex Outcome Treatment
    1 12 DAY