FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART XL+DEFIBRILLATOR/MONITOR
MDR report key: 4160813
·
Received July 23, 2014
Report
- Report Number
- 1218950-2014-04274
- Event Type
- Malfunction
- Date Received
- July 23, 2014
- Report Date
- July 1, 2014
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K110825
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CH
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4).
Description of Event or Problem · 1
THE CUSTOMER REPORTED THE DEVICE CANNOT FUNCTION. THERE WAS REPORTED PATIENT INVOLVEMENT WITH NO ADVERSE EFFECTS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 431031 | HEARTSTART XL+DEFIBRILLATOR/MONITOR | MKJ | PHILIPS MEDICAL SYSTEMS | 861290 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |