FDA Adverse Event
Malfunction
Summary report: N
HEARTSTART MRX
MDR report key: 9157107
·
Received October 4, 2019
Report
- Report Number
- 1218950-2019-07585
- Event Type
- Malfunction
- Date Received
- October 4, 2019
- Report Date
- September 16, 2019
- Manufacturer
- PHILIPS MEDICAL SYSTEMS
- Product Code
- MKJ
- PMA / PMN Number
- K031187
- Removal / Correction Number
- Z-1923-2019
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
IT WAS REPORTED TO PHILIPS THAT THE DEVICE WAS NOT POWERING THE AC LED AND WOULD NOT CHARGE THE INSTALLED BATTERY DUE TO A DEFECTIVE AC MODULE (023318 D0743C). THERE WAS NO REPORTED PATIENT INVOLVEMENT OR ADVERSE PATIENT/USER IMPACT AS A RESULT OF THE ALLEGED FAILURE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 953206 | HEARTSTART MRX | DEFIBRILLATOR | MKJ | PHILIPS MEDICAL SYSTEMS | M3535A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |