BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTREAM FR2

    MDR report key: 4214073 · Received October 24, 2014

    Report

    Report Number
    3030677-2014-02390
    Event Type
    Malfunction
    Date Received
    October 24, 2014
    Report Date
    September 25, 2014
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    MKJ
    PMA / PMN Number
    003565
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). DEVICE NOT RETURNED FOR EVAL.

    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
    678095 HEARTSTREAM FR2 MKJ PHILIPS MEDICAL SYSTEMS M3860A

    Patients

    Seq Age Sex Outcome Treatment
    1