HEARTSTART HOME M5068A 861282

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2020-03-18 for HEARTSTART HOME M5068A 861282 manufactured by Philips Medical Systems.

Event Text Entries

[186173691] It has been reported that the aed is not functioning properly.
Patient Sequence No: 1, Text Type: D, B5


[186174586] This issue was previously reported on pr 10300157 with mdr 3030677-2020-00392. The device investigation is pending.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3030677-2020-00530
MDR Report Key9850516
Report SourceCONSUMER
Date Received2020-03-18
Date of Report2020-03-10
Date Mfgr Received2020-03-10
Device Manufacturer Date2017-01-01
Date Added to Maude2020-03-18
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
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameHEARTSTART HOME
Generic NameAED
Product CodeNSA
Date Received2020-03-18
Model NumberM5068A
Catalog Number861282
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerPHILIPS MEDICAL SYSTEMS
Manufacturer Address22100 BOTHELL EVERETT HWY BOTHELL WA 98021 US 98021


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-18

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