FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART FRX
MDR report key: 3832441
·
Received March 27, 2014
Report
- Report Number
- 3030677-2014-00930
- Event Type
- Malfunction
- Date Received
- March 27, 2014
- Report Date
- March 11, 2014
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- 050004
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). PRODUCT EVALUATION PENDING. ISSUE IS BEING REPORTED AS ALERT COULD NOT BE CLEARED BY OPERATOR.
Description of Event or Problem · 1
IT HAS BEEN REPORTED THAT THE AED DID NOT PASS SELF DIAGNOSTIC CHECK.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 179705 | HEARTSTART FRX | MKJ | PHILIPS MEDICAL SYSTEMS | 861304 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |