BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    INTELLIVUE INFORMATION CENTER IX

    MDR report key: 7179832 · Received January 10, 2018

    Report

    Report Number
    1218950-2018-00286
    Event Type
    Malfunction
    Date Received
    January 10, 2018
    Report Date
    January 2, 2018
    Manufacturer
    PHILIPS MEDICAL SYSTEMS
    Product Code
    MHX
    UDI-DI
    00884838048645
    PMA / PMN Number
    K102495
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NH, US
    Reporter Occupation
    HEALTH PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    FCO(B)(4), FCO(B)(4), FCO (B)(4)

    Additional Manufacturer Narrative · 1

    A FOLLOW UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE.

    Description of Event or Problem · 1

    THE COMPLAINANT REPORTED THAT THE PHILIPS INTELLIVUE INFORMATION CENTER (PIIC) IX REBOOTS WHILE ATTEMPTING TO DISCHARGE A PATIENT. NO ADVERSE PATIENT EFFECTS EXPERIENCED DUE TO THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    24255 INTELLIVUE INFORMATION CENTER IX CENTRAL STATION MONITOR MHX PHILIPS MEDICAL SYSTEMS 866389 00884838048645

    Patients

    Seq Age Sex Outcome Treatment
    1