MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,u report with the FDA on 2018-12-27 for AVALON FM30 FETAL MONITOR M2703A manufactured by Philips Medical Systems.
[131471974]
A follow up report will be submitted once the investigation is complete. (b)(6).
Patient Sequence No: 1, Text Type: N, H10
[131471975]
The customer reported that on (b)(6) 2018 around 15:30 a baby was born in the delivery room with an apgr-0 score. Cardiopulmonary resuscitation (cpr) was performed and a claim was raised that the monitor did not provide coincidence inop (ccv).
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9610816-2018-00367 |
| MDR Report Key | 8198724 |
| Report Source | FOREIGN,HEALTH PROFESSIONAL,U |
| Date Received | 2018-12-27 |
| Date of Report | 2018-12-12 |
| Date of Event | 2018-12-10 |
| Date Mfgr Received | 2018-12-12 |
| Device Manufacturer Date | 2014-07-11 |
| Date Added to Maude | 2018-12-27 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. BETTY HARRIS |
| Manufacturer Street | HEWLETT-PACKARD STR.2 |
| Manufacturer City | BOEBLINGEN 71034 |
| Manufacturer Country | GM |
| Manufacturer Postal | 71034 |
| Manufacturer G1 | PHILIPS MEDICAL SYSTEMS |
| Manufacturer Street | 3000 MINUTEMAN ROAD |
| Manufacturer City | ANDOVER MA 01810 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 01810 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | AVALON FM30 FETAL MONITOR |
| Generic Name | FETAL MONITOR |
| Product Code | HGM |
| Date Received | 2018-12-27 |
| Model Number | M2703A |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | PHILIPS MEDICAL SYSTEMS |
| Manufacturer Address | HEWLETT-PACKARD STR.2 BOEBLINGEN 71034 GM 71034 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Life Threatening | 2018-12-27 |