BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VS4 VITAL SIGNS MONITOR

    MDR report key: 3905154 · Received June 10, 2014

    Report

    Report Number
    1218950-2014-03282
    Event Type
    Malfunction
    Date Received
    June 10, 2014
    Report Date
    May 14, 2014
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    DXN
    PMA / PMN Number
    K120132
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). A F/U REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE MONITOR FROZE UP WHILE IN USE. NO PATIENT HARM WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    338907 VS4 VITAL SIGNS MONITOR DXN PHILIPS MEDICAL SYSTEMS 863283

    Patients

    Seq Age Sex Outcome Treatment
    1