FDA Adverse Event Malfunction Summary report: N

INTELLIVUE MX500 PATIENT MONITOR

MDR report key: 8280811 · Received January 28, 2019

Report

Report Number
9610816-2019-00025
Event Type
Malfunction
Date Received
January 28, 2019
Report Date
January 23, 2019
Manufacturer
PHILIPS MEDICAL SYSTEMS
Product Code
MHX
UDI-DI
00884838038776
PMA / PMN Number
K131872
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 0

SUBMISSION OF A REPORT DOES NOT CONSTITUTE AN ADMISSION THAT MEDICAL PERSONNEL, USER FACILITY, IMPORTER, DISTRIBUTOR, MANUFACTURER, OR PRODUCT CAUSED OR CONTRIBUTED TO THE EVENT.

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

IT WAS REPORTED BY THE ICN STAFF; THE MONITOR DID NOT ALARM OR PRODUCE SOUND AT A CRITICAL MOMENT. THIS WAS REPORTED TO HAVE OCCURRED FROM THE EVENING OF (B)(6) 2019, AROUND 3:00AM. IT SHOULD HAVE BEEN A RED BRADY ALARM. NO ADVERSE EVENT OR PATIENT HARM WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
73523 INTELLIVUE MX500 PATIENT MONITOR PATIENT MONITOR MHX PHILIPS MEDICAL SYSTEMS 866064 00884838038776

Patients

Seq Age Sex Outcome Treatment
1