FDA Adverse Event Malfunction Summary report: N

HEARTSTART XL + DEFIBRILLATOR/MONITOR

MDR report key: 3770465 · Received March 5, 2014

Report

Report Number
1218950-2014-01182
Event Type
Malfunction
Date Received
March 5, 2014
Report Date
February 10, 2014
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MKJ
PMA / PMN Number
K110825
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
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 TO PHILLIPS HEALTHCARE THAT THE HEARTSTART XL = HAD AND ECG DEVICE FAILURE MESSAGE. THERE WAS NO NEGATIVE PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
134105 HEARTSTART XL + DEFIBRILLATOR/MONITOR MKJ PHILIPS MEDICAL SYSTEMS 861290

Patients

Seq Age Sex Outcome Treatment
1