FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART MRX
MDR report key: 3810561
·
Received April 16, 2014
Report
- Report Number
- 1218950-2014-02155
- Event Type
- Malfunction
- Date Received
- April 16, 2014
- Report Date
- March 27, 2014
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K031187
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SP
- Reporter Occupation
- UNKNOWN
Narratives
Additional Manufacturer Narrative · 1
(B)(4). A FOLLOW REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.
Description of Event or Problem · 1
IT WAS REPORTED TO PHILIPS HEALTHCARE THAT THE HEARTSTART MRX FAILED OPCHECK, IT WAS LATER CLARIFIED THAT THE PHILIPS FIELD SERVICE ENGINEER (FSE) FAILED OPERATIONAL CHECK FOR PACE. THERE WAS NO PT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 233626 | HEARTSTART MRX | MKJ | PHILIPS MEDICAL SYSTEMS | M3535A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |