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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHILIPS NORTH AMERICA LLC FR2+ AED, NO-ECG, CHINA

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PHILIPS NORTH AMERICA LLC FR2+ AED, NO-ECG, CHINA Back to Search Results
Model Number 861459
Medical Device Problem Code Premature Discharge of Battery (1057)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It has been reported that the device will not power on.
 
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Brand Name
FR2+ AED, NO-ECG, CHINA
Common Device Name
AED
Manufacturer (Section D)
PHILIPS NORTH AMERICA LLC
22100 bothell everett highway
bothell WA 98021
Manufacturer (Section G)
PHILIPS NORTH AMERICA LLC
22100 bothell everett highway
bothell WA 98021
Manufacturer Contact
tanya deschmidt
22100 bothell everett highway
bothell, WA 98021
9095703538
MDR Report Key22865693
Report Number3030677-2025-001916
Device Sequence Number7632369
Product Code MKJ
UDI-Device Identifier00884838050396
UDI-Public(01)00884838050396
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K051632
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Consumer
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 09/18/2025
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 Other
Device Model Number861459
Device Catalogue Number989803128011
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/14/2025
Supplement Date Received by Manufacturer09/18/2025
Initial Report FDA Received Date08/21/2025
Supplement Report FDA Received Date09/18/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured05/01/2008
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 A
Patient Sequence Number1
Patient SexUnknown
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