FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART XL+ DEFIBRILLATOR/MONITOR
MDR report key: 4092461
·
Received September 8, 2014
Report
- Report Number
- 1218950-2014-05358
- Event Type
- Malfunction
- Date Received
- September 8, 2014
- Report Date
- August 13, 2014
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K110825
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4).
Description of Event or Problem · 1
IT WAS REPORTED TO PHILIPS THAT THE HEARTSTART XL+ DEFIBRILLATOR FAILED THE OPCHECKS TEST FOR EQUIPMENT DISABLED THERAPY MESSAGE. THERE WAS NO REPORT OF PT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 551100 | HEARTSTART XL+ DEFIBRILLATOR/MONITOR | MKJ | PHILIPS MEDICAL SYSTEMS | 861290 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |