BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTART XL+DEFIBRILLATOR/MONITOR

    MDR report key: 3770472 · Received March 5, 2014

    Report

    Report Number
    1218950-2014-01193
    Event Type
    Malfunction
    Date Received
    March 5, 2014
    Report Date
    February 11, 2014
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    MKJ
    PMA / PMN Number
    K110825
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, 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 STATES THAT THE DEVICE IS DISABLED. THERE WAS NO PT INVOLVEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    133496 HEARTSTART XL+DEFIBRILLATOR/MONITOR MKJ PHILIPS MEDICAL SYSTEMS 861290

    Patients

    Seq Age Sex Outcome Treatment
    1