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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHILIPS NORTH AMERICA LLC FR2+ DEFIB, TEXT, ITALIAN, EXCHANGE; AED

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PHILIPS NORTH AMERICA LLC FR2+ DEFIB, TEXT, ITALIAN, EXCHANGE; AED Back to Search Results
Model Number 861459
Medical Device Problem Code Failure of Device to Self-Test (2937)
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 is failing self-test.
 
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Brand Name
FR2+ DEFIB, TEXT, ITALIAN, EXCHANGE
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 Key23778384
Report Number3030677-2025-002612
Device Sequence Number15936173
Product Code MKJ
UDI-Device Identifier00884838050396
UDI-Public(01)00884838050396
Combination Product (Y/N)N
Initial Reporter CountryIT
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
Report Date (Section B) 12/11/2025
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 NumberM3861-RFABZ
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/04/2025
Initial Report FDA Received Date12/11/2025
Date Device Manufactured03/01/2005
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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