BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTART MRX- EMS DEFIB

    MDR report key: 3821636 · Received January 16, 2014

    Report

    Report Number
    1218950-2014-00181
    Event Type
    Malfunction
    Date Received
    January 16, 2014
    Report Date
    December 20, 2013
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    MKJ
    PMA / PMN Number
    K031187
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SP
    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 THAT THE DEVICE FAILS THE DEFIB TEST. THERE WAS NO PT INVOLVEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    43778 HEARTSTART MRX- EMS DEFIB MKJ PHILIPS MEDICAL SYSTEMS M3536A

    Patients

    Seq Age Sex Outcome Treatment
    1