FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART XL + DEFIBRILLATOR/MONITOR
MDR report key: 3221585
·
Received July 1, 2013
Report
- Report Number
- 1218950-2013-02748
- Event Type
- Malfunction
- Date Received
- July 1, 2013
- Report Date
- June 4, 2013
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K110825
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MA, 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 REPORTED THAT THEY RECEIVED AN ERROR MESSAGE STATING "LOCKED OUT CRITICAL ERROR." THERE WAS NO PATIENT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 298186 | HEARTSTART XL + DEFIBRILLATOR/MONITOR | MKJ | PHILIPS MEDICAL SYSTEMS | 861290 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |