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