MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2019-03-04 for manufactured by Philips Medical Systems.

Event Text Entries

[137805626]
Patient Sequence No: 1, Text Type: N, H10


[137805627] It has been reported that the philips brand pads that were used with a non-philips defibrillator burned a patient during a patient use event. The patient outcome is unknown.
Patient Sequence No: 1, Text Type: D, B5


[138105862] Please note, this was not a 5 day report.
Patient Sequence No: 1, Text Type: N, H10


[138892389]
Patient Sequence No: 1, Text Type: N, H10


[138892390] New information from the user confirmed the patient survived. It has been reported that the philips brand pads that were used with a non-philips defibrillator burned a patient during a patient use event. The patient outcome is unknown.
Patient Sequence No: 1, Text Type: D, B5


[142026637] .
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3030677-2019-00440
MDR Report Key8388284
Report SourceUSER FACILITY
Date Received2019-03-04
Date of Report2019-02-28
Date Mfgr Received2019-02-28
Date Added to Maude2019-03-04
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMRS. DANA TACKETT
Manufacturer Street22100 BOTHELL EVERETT HWY
Manufacturer CityBOTHELL WA 98021
Manufacturer CountryUS
Manufacturer Postal98021
Manufacturer G1PHILIPS HEALTHCARE - BOTHELL
Manufacturer Street22100 BOTHELL-EVERETT HWY BLDG A
Manufacturer CityBOTHELL WA 98021
Manufacturer CountryUS
Manufacturer Postal Code98021
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameNA
Generic NameNA
Product CodeMLN
Date Received2019-03-04
Model NumberNA
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerPHILIPS MEDICAL SYSTEMS
Manufacturer Address22100 BOTHELL EVERETT HWY BOTHELL WA 98021 US 98021


Patients

Patient NumberTreatmentOutcomeDate
10 2019-03-04

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