FDA Adverse Event
Malfunction
Summary report: N
INTELLIVUE INFORMATION CENTER IX
MDR report key: 7193912
·
Received January 16, 2018
Report
- Report Number
- 1218950-2018-00477
- Event Type
- Malfunction
- Date Received
- January 16, 2018
- Report Date
- January 2, 2018
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MHX
- PMA / PMN Number
- K102495
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SC, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
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 CUSTOMER REPORTED THAT THE IX WAS REBOOTING AFTER DISCHARGING A PATIENT. THERE WAS NO PATIENT INCIDENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 41775 | INTELLIVUE INFORMATION CENTER IX | CENTRAL STATION MONITOR | MHX | PHILIPS MEDICAL SYSTEMS | 866389 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |