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