BEUDAMED
    FDA Adverse Event Death Summary report: N

    AGILENT INFORMATION CENTER

    MDR report key: 370642 · Received January 8, 2002

    Report

    Report Number
    1218950-2002-00004
    Event Type
    Death
    Date Received
    January 8, 2002
    Date of Event
    December 9, 2001
    Report Date
    December 10, 2001
    Manufacturer
    PHILIPS MEDICAL SYSTEMS, INC.
    Product Code
    DRT
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THERE WERE NO ALARMS FROM THE MONITOR WHEN THE PT WENT INTO V-TACH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AGILENT INFORMATION CENTER CENTRAL STATION MONITOR DRT PHILIPS MEDICAL SYSTEMS, INC. M3150A NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Death