FDA Adverse Event Malfunction Summary report: N

HEARTSTART MRX-EMS DEFIBRILLATOR

MDR report key: 3182456 · Received June 11, 2013

Report

Report Number
1218950-2013-02271
Event Type
Malfunction
Date Received
June 11, 2013
Report Date
May 13, 2013
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MKJ
PMA / PMN Number
K031187
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
UNKNOWN

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 REPORTED THAT THE DEVICE FAILED THE OPERATIONAL CHECK. THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
264579 HEARTSTART MRX-EMS DEFIBRILLATOR MKJ PHILIPS MEDICAL SYSTEMS M3536A

Patients

Seq Age Sex Outcome Treatment
1