FDA Adverse Event Malfunction Summary report: N

HEARTSTART FR3 ECG, BASIC BUNDLE, UKENG

MDR report key: 4102682 · Received August 28, 2014

Report

Report Number
3030677-2014-01975
Event Type
Malfunction
Date Received
August 28, 2014
Report Date
August 27, 2014
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MKJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). PRODUCT EVAL 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
524117 HEARTSTART FR3 ECG, BASIC BUNDLE, UKENG MKJ PHILIPS MEDICAL SYSTEMS 861389

Patients

Seq Age Sex Outcome Treatment
1