FDA Adverse Event
Death
Summary report: N
HEARTSTREAM FR2
MDR report key: 6126161
·
Received November 23, 2016
Report
- Report Number
- 3030677-2016-02806
- Event Type
- Death
- Date Received
- November 23, 2016
- Report Date
- November 23, 2016
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- 003565
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
THE USER IS QUESTIONING THE "ANALYZING PATIENT" AND "ANALYZING WAS DISRUPTED"VOICE PROMPTS THE DEVICE ISSUED DURING A PATIENT USE EVENT. THE PATIENT DID NOT SURVIVE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 776663 | HEARTSTREAM FR2 | AED | MKJ | PHILIPS MEDICAL SYSTEMS | M3841A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Death |