FDA Adverse Event
Malfunction
Summary report: N
HEART START XL
MDR report key: 6107387
·
Received November 16, 2016
Report
- Report Number
- 1218950-2016-07242
- Event Type
- Malfunction
- Date Received
- November 16, 2016
- Report Date
- October 19, 2016
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K001725
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SF
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE.
Description of Event or Problem · 1
IT WAS REPORTED TO PHILIPS THAT THE DEVICE "CANNOT DISCHARGE." THERE WAS NO REPORTED PATIENT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 758579 | HEART START XL | DEFIBRILLATOR | MKJ | PHILIPS MEDICAL SYSTEMS | M4735A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |