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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHILIPS MEDIZIN SYSTEME BÖBLINGEN GMBH INTELLIVUE X3
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PHILIPS MEDIZIN SYSTEME BÖBLINGEN GMBH INTELLIVUE X3 Back to Search Results
Model Number 867030
Device Problem False Alarm (1013)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/07/2022
Event Type  malfunction  
Event Description
It was reported that the customer had questions about the extreme alarm settings, as they were unable to get red alarms.The device was reported to be in use on a patient, but no adverse event to patient or user was reported.
 
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Brand Name
INTELLIVUE X3
Type of Device
INTELLIVUE X3
Manufacturer (Section D)
PHILIPS MEDIZIN SYSTEME BÖBLINGEN GMBH
hewlett-packard-str. 2,
b1-3/d6
boblingen 71034
GM  71034
Manufacturer (Section G)
PHILIPS MEDIZIN SYSTEME BÖBLINGEN GMBH
hewlett-packard-str. 2,
b1-3/d6
boblingen 71034
GM   71034
Manufacturer Contact
derek sammarco
222 jacobs st
cambridge, MA 02141
6172455900
MDR Report Key14251417
MDR Text Key290393180
Report Number9610816-2022-00212
Device Sequence Number1
Product Code MHX
UDI-Device Identifier00884838082588
UDI-Public00884838082588
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K171801
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,User Facility
Reporter Occupation Biomedical Engineer
Type of Report Initial
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number867030
Device Catalogue Number867030
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 04/07/2022
Initial Date FDA Received04/29/2022
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured10/15/2020
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
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