FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART XL+ DEFIBRILLATOR/MONITOR
MDR report key: 8663300
·
Received June 3, 2019
Report
- Report Number
- 1218950-2019-03946
- Event Type
- Malfunction
- Date Received
- June 3, 2019
- Report Date
- May 6, 2019
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K110825
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
IT WAS REPORTED THAT THE DEVICE CAN¿T BOOT UP. THERE IS NO PATIENT INVOLVEMENT. THE EFFICIA DFM100 DEFIBRILLATOR, MODEL# 866199, IS SUBSTANTIALLY SIMILAR TO THE HEARTSTART XL+ DEFIBRILLATOR (MODEL # 861290) AND WILL BE REPORTED IN THE UNITED STATES UNDER DEVICE MODEL # 861290.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 455033 | HEARTSTART XL+ DEFIBRILLATOR/MONITOR | XL+ DEFIBRILLATOR | MKJ | PHILIPS MEDICAL SYSTEMS | 861290 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |