FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART HOME
MDR report key: 7898172
·
Received September 21, 2018
Report
- Report Number
- 3030677-2018-02101
- Event Type
- Malfunction
- Date Received
- September 21, 2018
- Report Date
- September 17, 2018
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- NSA
- PMA / PMN Number
- K040904
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FR
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
IT HAS BEEN REPORTED THAT THE DEVICE IS FAILING SELF-TEST.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 740281 | HEARTSTART HOME | AED | NSA | PHILIPS MEDICAL SYSTEMS | M5068A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |