FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART XL+ DEFIBRILALTOR/MONITOR
MDR report key: 3931462
·
Received April 14, 2014
Report
- Report Number
- 1218950-2014-02080
- Event Type
- Malfunction
- Date Received
- April 14, 2014
- Report Date
- March 24, 2014
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K110825
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GM
- Reporter Occupation
- UNKNOWN
Narratives
Additional Manufacturer Narrative · 1
PR#: (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 GENERATED A THERAPY/SYSTEM ERROR MESSAGE WHILE NOT IN USE. THERE WAS NO PT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 226641 | HEARTSTART XL+ DEFIBRILALTOR/MONITOR | MKJ | PHILIPS MEDICAL SYSTEMS | 861290 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |