FDA Adverse Event Death Summary report: N

MP60 INTELLIVUE PATIENT MONITOR

MDR report key: 5041926 · Received August 31, 2015

Report

Report Number
9610816-2015-00191
Event Type
Death
Date Received
August 31, 2015
Date of Event
August 17, 2015
Report Date
August 18, 2015
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MHX
PMA / PMN Number
K030038
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

A FOLLOW UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE. (B)(4).

Additional Manufacturer Narrative · 1

.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE DEVICE DID NOT ALARM FOR A VTACH ON (B)(6) 2015 AT AROUND 5 PM. THE PATIENT PASSED AWAY ON (B)(6) 2015.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE DEVICE DID NOT ALARM FOR A VTACH ON (B)(6) 2015 AT AROUND 5 PM. THE PATIENT PASSED AWAY ON (B)(6) 2015.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
574462 MP60 INTELLIVUE PATIENT MONITOR COMPACT PATIENT MONITOR MHX PHILIPS MEDICAL SYSTEMS M8005A

Patients

Seq Age Sex Outcome Treatment
1 Death