FDA Adverse Event Malfunction Summary report: N

FR3, REFURB ECG AED - US ENGLISH

MDR report key: 3963046 · Received June 11, 2014

Report

Report Number
3030677-2014-01432
Event Type
Malfunction
Date Received
June 11, 2014
Report Date
May 22, 2014
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MKJ
PMA / PMN Number
K111693
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
HI, US
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
345429 FR3, REFURB ECG AED - US ENGLISH MKJ PHILIPS MEDICAL SYSTEMS 861389

Patients

Seq Age Sex Outcome Treatment
1