FDA Adverse Event
Malfunction
Summary report: N
MX40 1.4 GHZ SMART HOPPING
MDR report key: 3960991
·
Received May 23, 2014
Report
- Report Number
- 1218950-2014-02924
- Event Type
- Malfunction
- Date Received
- May 23, 2014
- Report Date
- May 15, 2014
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- DSI
- PMA / PMN Number
- K113125
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NJ, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
PR # (B)(4). A F/U REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETED.
Description of Event or Problem · 1
THE CUSTOMER REPORTED THAT THERE WAS NO AUDIO FROM THEIR MX40 DEVICE. THERE WAS NO REPORT OF PT HARM.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 309319 | MX40 1.4 GHZ SMART HOPPING | DSI | PHILIPS MEDICAL SYSTEMS | 865350 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |