BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTART MRX EMS DEFIBRILLATOR

    MDR report key: 4182090 · Received August 4, 2014

    Report

    Report Number
    1218950-2014-04513
    Event Type
    Malfunction
    Date Received
    August 4, 2014
    Report Date
    July 11, 2014
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    MKJ
    PMA / PMN Number
    K031187
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). A FOLLOW UP REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

    Description of Event or Problem · 1

    IT WAS REPORTED TO PHILIPS THAT THE ETCO2 PORT IS PUSHED INTO THE DEVICE. THERE WAS NO PATIENT INVOLVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    453096 HEARTSTART MRX EMS DEFIBRILLATOR MKJ PHILIPS MEDICAL SYSTEMS M3536A

    Patients

    Seq Age Sex Outcome Treatment
    1