FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART MRX AIRWORTHY
MDR report key: 3981296
·
Received June 20, 2014
Report
- Report Number
- 1218950-2014-03605
- Event Type
- Malfunction
- Date Received
- June 20, 2014
- Report Date
- May 29, 2014
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K031187
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). A FOLLOW UP REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.
Description of Event or Problem · 1
IT WAS REPORTED TO PHILIPS HEALTHCARE THAT THE HEARTSTART MRX DEFIBRILLATOR'S CO2 PUMP WAS NOT WORKING. THERE WAS NO PT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 364335 | HEARTSTART MRX AIRWORTHY | DRO, LDD, MKJ | MKJ | PHILIPS MEDICAL SYSTEMS | 861464 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |