MAUDE MDR 3970166

MDR report key
3970166
Report number
1218950-2014-02403
Event key
0
Event type
3
Date received
2014-04-29
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
0
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
NANCY ATAIDE
Address
3000 MINUTEMAN RD. ANDOVER MA 01810 US
Phone
978-978-9786
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1HEART START XLPHILIPS MEDICAL SYSTEMSMJKM4735AN Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12014-04-290

Event Narratives#

D

Patient 1

THE CUSTOMER REPORTED THAT THE BATTERY FAILS THE 3 HR HOLDING TEST. THERE WAS NO PT INVOLVEMENT.

N

Patient 1

PR#: (B)(4). A FOLLOW UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETED.