BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTART MRX

    MDR report key: 4080852 · Received August 25, 2014

    Report

    Report Number
    1218950-2014-05069
    Event Type
    Malfunction
    Date Received
    August 25, 2014
    Report Date
    August 1, 2014
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    MKJ
    PMA / PMN Number
    K031187
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4).

    Description of Event or Problem · 1

    DURING THE PHILIPS BENCH EVALUATION FOR A PACING ISSUE, A PHILIPS REPAIR BENCH TECHNICIAN OBSERVED A BENT CONTACT PIN IN SLOT B ON THE BATTERY PCA. THERE WAS NO PATIENT INVOLVEMENT WHERE THIS OCCURRED DURING SERVICING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    510693 HEARTSTART MRX MKJ PHILIPS MEDICAL SYSTEMS M3535A

    Patients

    Seq Age Sex Outcome Treatment
    1