BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTART MRX AIRWORTHY

    MDR report key: 3170490 · Received May 24, 2013

    Report

    Report Number
    1218950-2013-01992
    Event Type
    Malfunction
    Date Received
    May 24, 2013
    Report Date
    April 30, 2013
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    MKJ
    PMA / PMN Number
    K031187
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). A FOLLOW UP REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

    Description of Event or Problem · 1

    THE CUSTOMER REQUESTED A PART NUMBER FOR A BATTERY. THE REPLACEMENT OF A BATTERY COULD INDICATE A POSSIBLE MALFUNCTION OF THE DEVICE. THERE WAS NO REPORT OF PATIENT INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    230682 HEARTSTART MRX AIRWORTHY DRO LDD MKJ MKJ PHILIPS MEDICAL SYSTEMS 861464

    Patients

    Seq Age Sex Outcome Treatment
    1