FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART FR3 ECG, BASIC BUNDLE, EUROPE
MDR report key: 3837596
·
Received April 11, 2014
Report
- Report Number
- 3030677-2014-01047
- Event Type
- Malfunction
- Date Received
- April 11, 2014
- Report Date
- April 3, 2014
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GM
- 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. 510 (K): K111693.
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 |
|---|---|---|---|---|---|---|---|
| 220983 | HEARTSTART FR3 ECG, BASIC BUNDLE, EUROPE | MKJ | PHILIPS MEDICAL SYSTEMS | 861389 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |