FDA Adverse Event
Malfunction
Summary report: N
FR3, REFURB ECG AED, LANGUAGE CONFIGURAB
MDR report key: 3050318
·
Received March 14, 2013
Report
- Report Number
- 3030677-2013-00463
- Event Type
- Malfunction
- Date Received
- March 14, 2013
- Report Date
- February 26, 2013
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K111693
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FR
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). PRODUCT EVAL PENDING. ISSUE IS BEING REPORTED AS ALERT COULD NOT BE CLEARED BY OPERATOR.
Description of Event or Problem · 1
THE AED IS NOT FUNCTIONING PROPERLY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 108531 | FR3, REFURB ECG AED, LANGUAGE CONFIGURAB | MKJ | PHILIPS MEDICAL SYSTEMS | 861389 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |