BEUDAMED
    FDA Adverse Event Death Summary report: N

    PHILIPS INTELLIVUE MX40

    MDR report key: 3232783 · Received July 11, 2013

    Report

    Report Number
    3232783
    Event Type
    Death
    Date Received
    July 11, 2013
    Date of Event
    June 29, 2013
    Report Date
    July 10, 2013
    Manufacturer
    PHILIPS MEDICAL SYSTEM
    Product Code
    DSI
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PATIENT WAS ON TELEMETRY MONITORING. MONITOR WAS REMOVED AND SYSTEM WAS PUT INTO STANDBY MODE WHILE BEING SENT FOR A CT EXAM. UPON RETURN TO DEPT PATIENT WAS RECONNECTED TO TELEMETRY MONITOR BUT MONITOR NEVER RECONNECTED TO THE CENTRAL STATION. DURING ROUNDS PATIENT WAS FOUND UNRESPONSIVE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    320442 PHILIPS INTELLIVUE MX40 TELEMETRY TRANSMITTER DSI PHILIPS MEDICAL SYSTEM INTELLIVUE MX40

    Patients

    Seq Age Sex Outcome Treatment
    1 80 YR Death