Class 2 Device Recall IntelliVue Patient Monitor

• Date Initiated by Firm: August 30, 2024
• Date Posted: September 25, 2024
• Recall Status: Open, Classified
• Recall Number: Z-3249-2024
• Recall Event ID: 95295
• 510(K)Number: K130849 K131872
• Product Classification: Monitor, physiological, patient(with arrhythmia detection or alarms) - Product Code MHX
• Product: IntelliVue Patient Monitor MX400 (Model Number 866060), MX430 (Model Number 866061), MX450 (Model Number 866062), MX500 (Model Number 866064), and MX550 (Model Number 866066)
• Code Information: IntelliVue Patient Monitor MX400, 866060, UDI-DI: 00884838038752; IntelliVue Patient Monitor MX430, 866061, UDI-DI: 00884838057562; IntelliVue Patient Monitor MX450, 866062, UDI-DI: 00884838038769; IntelliVue Patient Monitor MX500, 866064, UDI-DI: 00884838038776; IntelliVue Patient Monitor MX550, 866066, UDI-DI: 00884838038783; Only MX400-550 devices shipped after 26-April-2024 are affected. Please refer to the manufacturing date on the back of your monitor.
• FEI Number: 3006648320
• Recalling Firm/ Manufacturer: Philips North America; 222 Jacobs St; Cambridge MA 02141-2296
• For Additional Information Contact: Philips Customer Services; 800-722-9377
• Manufacturer Reason for Recall: During a production process, Philips became aware of one IntelliVue power supply with a broken ground bolt upon disconnection of the ground cable from the equipotential ground connector. Loss of electrical grounding may negatively affect the devices electromagnetic immunity and emission.
• FDA Determined Cause: Nonconforming Material/Component
• Action: An URGENT Medical Device Correction notification letter dated 8/30/24 was sent to customers. Actions that should be taken by the customer / user to prevent risks for patients or users " Please check if the equipotential connector is broken off (refer to Figure 1). If yes, remove the device from use. " Pass this notice to all those who need to be aware within your organization or to any organization where affected devices have been potentially transferred. " Customers should complete the URGENT Medical Device Response Form either via the QR code below or at the end of the notification to submit both their acknowledgment of this recall and confirm understanding of actions to be taken. If hard copy of Response Form is completed in lieu of digital version (via QR code) please return to Philips at recall.responsephilips.com. You may also fax it to 877 499 7223. Actions planned by Philips to correct the problem A Philips representative will contact you to schedule a visit from a Philips Field Service Engineer who will replace the power supply. If you need any further information, please contact your local Philips representative, or call 1-800-722-9377. Distributors: Philips is requesting customers to return a Response Form to acknowledge receipt and understanding of the URGENT Medical Device Correction and confirm that the information from this Letter has been properly distributed to all users that handle the affected product. Together with this letter we are providing a list of affected products that Philips has sold to your organization. As distributor of the affected products, we kindly request that you: o Add in the Response Form attached your contact information. o Send the attached URGENT Medical Device Correction to each customer to whom you have distributed any affected product as soon as possible and no later than three days, together with the Reply Card. o Perform a good faith effort to get the Reply Form by following up with the customer with a minimum of t
• Quantity in Commerce: 545 devices
• Distribution: US Nationwide. Global Distribution.
• Total Product Life Cycle: TPLC Device Report

¹ A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
² Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
³ The manufacturer has initiated the recall and not all products have been corrected or removed. This record will be updated as the status changes.

• 510(K) Database: 510(K)s with Product Code = MHX