BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTART FR3 ECG, BASIC BUNDLE, JAPAN

    MDR report key: 4142680 · Received September 26, 2014

    Report

    Report Number
    3030677-2014-02147
    Event Type
    Malfunction
    Date Received
    September 26, 2014
    Report Date
    September 12, 2014
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    MKJ
    PMA / PMN Number
    K111693
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    PR#: (B)(4). UDI#: N/A.

    Description of Event or Problem · 1

    IT HAS BEEN REPORTED THAT THE DEVICE PROMPTS WERE NOT FUNCTIONING PROPERLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    600140 HEARTSTART FR3 ECG, BASIC BUNDLE, JAPAN MKJ PHILIPS MEDICAL SYSTEMS 861389

    Patients

    Seq Age Sex Outcome Treatment
    1