MAUDE Adverse Event Report: PHILIPS MEDIZIN SYSTEME BÖBLINGEN GMBH AVALON TOCO MP TRANSDUCER

Model Number	M2734B
Medical Device Problem Code	Incorrect Measurement (1383)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	05/19/2022
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Reporter institution phone number (b)(6).Reporter phone number (b)(6).A follow up report will be submitted once the investigation is complete.
Event or Problem Description
The customer reported: " avalon toco mp transducer device leads incorrectly".It is unknown if the device was in use at time of event and no adverse event to the patient/user was reported.
Event or Problem Description
The customer reported: " avalon toco mp transducer device leads incorrectly".It is unknown if the device was in use at time of event and no adverse event to the patient/user was reported.

• Brand Name: AVALON TOCO MP TRANSDUCER
• Common Device Name: AVALON TOCO MP TRANSDUCER
• 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: jeanne ahearn ; 222 jacobs st; cambridge, MA 02141 ; 6172455900
• MDR Report Key: 14567651
• Report Number: 9610816-2022-00306
• Device Sequence Number: 5157041
• Product Code: MHX
• UDI-Device Identifier: 00884838021471
• UDI-Public: 00884838021471
• Combination Product (Y/N): N
• Initial Reporter Country: AU
• PMA/510(K) Number: K110622
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Foreign,Health Professional,User Facility
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup

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
• Operator of Device: Health Professional
• Device Model Number: M2734B
• Device Catalogue Number: M2734B
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 05/19/2022
• Supplement Date Received by Manufacturer: 08/20/2022
• Initial Report FDA Received Date: 06/01/2022
• Supplement Report FDA Received Date: 09/08/2022
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 01/15/2014
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Reuse
• Patient Sequence Number: 1
• Patient Sex: Unknown