BEUDAMED
    FDA Adverse Event Death Summary report: N

    PHILIPS/DATA CRITICAL STAT VIEW PAGER

    MDR report key: 489173 · Received September 19, 2003

    Report

    Report Number
    489173
    Event Type
    Death
    Date Received
    September 19, 2003
    Date of Event
    August 28, 2003
    Report Date
    September 19, 2003
    Manufacturer
    PHILIPS MEDICAL SYSTEMS, INC.
    Product Code
    MSX
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NY, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    WHILE THE PT WAS BEING MONITORED ON TELEMETRY, THEY DEVELOPED EPISODES OF VENTRICULAR TACHYCARDIA AT TWO DIFFERENT INTERVALS WITHIN 3 MINUTES OF EACH OTHER. THE LAST EPISODE RESULTED IN ASYSTOLE. THE TELEMETRY TRANSMITTER PAGERS FAILED TO ALARM AND NOTIFY THE PRIMARY NURSE AND OTHER NURSING STAFF THAT THE PT HAD AN ABNORMAL HEART RHYTHM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PHILIPS/DATA CRITICAL STAT VIEW PAGER PAGER MSX PHILIPS MEDICAL SYSTEMS, INC. PN: 300-0317-03 *

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Death