BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEARTSTART FRX

    MDR report key: 5092432 · Received September 21, 2015

    Report

    Report Number
    3030677-2015-02240
    Event Type
    Malfunction
    Date Received
    September 21, 2015
    Report Date
    September 8, 2015
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    MKJ
    PMA / PMN Number
    050004
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4).

    Additional Manufacturer Narrative · 1

    (B)(4).

    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
    623634 HEARTSTART FRX AED MKJ PHILIPS MEDICAL SYSTEMS 861304 61674-P

    Patients

    Seq Age Sex Outcome Treatment
    1