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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHILIPS MEDIZIN SYSTEME BÖBLINGEN GMBH INTELLIVUE MX430 PATIENT MONITOR

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PHILIPS MEDIZIN SYSTEME BÖBLINGEN GMBH INTELLIVUE MX430 PATIENT MONITOR Back to Search Results
Model Number 866061
Medical Device Problem Code No Audible Alarm (1019)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/22/2023
Type of Reportable Event Malfunction
Event or Problem Description
Philips received a complaint on the intellivue mx430 patient monitor indicating that the device displayed a speaker failure message and the speaker did not produce sound.The device was not in use.No adverse event was reported.
 
Additional Manufacturer Narrative
A philips response service engineer (rse) spoke to the customer about the issue.The rse determined the speaker needed to be replaced.Results of functional testing indicate the device speaker was faulty.The customer ordered a replacement speaker assembly.We will consider that the customer resolved the issue using the replacement parts ordered from philips.The investigation concludes that no further action is required at this time.If additional information is received the complaint file will be reopened.
 
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Brand Name
INTELLIVUE MX430 PATIENT MONITOR
Common Device Name
INTELLIVUE MX430 PATIENT MONITOR
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
hauke schik
hewlett-packard-str. 2,
b1-3/d6
boblingen 71034
GM   71034
70314632031
MDR Report Key16768987
Report Number9610816-2023-00172
Device Sequence Number11576037
Product Code MWI
UDI-Device Identifier00884838006379
UDI-Public00884838006379
Combination Product (Y/N)N
Initial Reporter CountryIN
PMA/510(K) Number
K090785
Number of Events Summarized1
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 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
Operator of Device Health Professional
Device Model Number866061
Device Catalogue Number866061
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/22/2023
Initial Report FDA Received Date04/19/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/10/2017
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 Number1
Patient SexUnknown
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