BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PHILLIPS TELEMETRY PAK

    MDR report key: 3193451 · Received June 21, 2013

    Report

    Report Number
    MW5030667
    Event Type
    Malfunction
    Date Received
    June 21, 2013
    Report Date
    June 21, 2013
    Manufacturer
    PHILLIPS HEALTHCARE
    Product Code
    DSI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WV, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    TELEMETRY PAKS NOT TRANSFERRING THE PT WAVE FORM. PROBLEM IS OCCURRING WITH MULTIPLE PACKS OF THE SAME SYSTEM ON THE SAME FLOOR BUT NOT AT THE SAME TIME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    281843 PHILLIPS TELEMETRY PAK TELEMETRY PAK DSI PHILLIPS HEALTHCARE MX40-1B4 NA

    Patients

    Seq Age Sex Outcome Treatment
    1