FDA Adverse Event
Injury
Summary report: N
HEARTSTART XL
MDR report key: 4196919
·
Received October 15, 2014
Report
- Report Number
- 1218950-2014-06186
- Event Type
- Injury
- Date Received
- October 15, 2014
- Report Date
- September 23, 2014
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MJK
- PMA / PMN Number
- K001725
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TW
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). A FOLLOW UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE.
Description of Event or Problem · 1
THE CUSTOMER REPORTED, THE XL DEVICE CANNOT "BOOT UP". THERE WAS NO REPORT OF PT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 655198 | HEARTSTART XL | MJK | PHILIPS MEDICAL SYSTEMS | M4735A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |