MAUDE Adverse Event Report: PHILIPS MEDICAL SYSTEMS NEDERLAND B.V. AZURION; INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM

Model Number	AZURION 5 M12
Medical Device Problem Code	Radiation Output Failure (4027)
Health Effect - Clinical Code	Cardiac Arrest (1762)
Date of Event	03/23/2026
Type of Reportable Event	Death
Event or Problem Description
It was reported to philips that at the start of an emergency percutaneous coronary intervention (pci), there was an issue related to the system¿s x ray exposure and/or geometry (table) movement, and that prior to/simultaneously with/after the attempt to start the procedure, the patient experienced a cardiac arrest and required cardiopulmonary resuscitation (cpr).Cpr was administered for approximately 45 minutes; however, the patient could not be resuscitated.Philips has initiated an investigation into the reported complaint, which, at this time, is still characterized by incomplete and/or seemingly conflicting information.An investigation into this complaint has been initiated by philips.

• Brand Name: AZURION
• Common Device Name: INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM
• Manufacturer (Section D): PHILIPS MEDICAL SYSTEMS NEDERLAND B.V.; veenpluis 6; best 5684 PC; NL 5684 PC
• Manufacturer (Section G): PHILIPS MEDICAL SYSTEMS NEDERLAND B.V.; veenpluis 6; best 5684 PC; NL 5684 PC
• Manufacturer Contact: marjan vos ; veenpluis 6; best 5684 -PC ; NL 5684 PC
• MDR Report Key: 24896723
• Report Number: 3003768277-2026-101057
• Device Sequence Number: 8763843
• Product Code: OWB
• UDI-Device Identifier: 00884838099227
• UDI-Public: (01)00884838099227
• Combination Product (Y/N): N
• Initial Reporter Country: IN
• PMA/510(K) Number: K200917
• 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,Company Representative
• Initial Reporter Occupation: Physician
• Type of Report: Initial
• Report Date (Section B): 04/16/2026

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Operator of Device: Health Professional
• Device Model Number: AZURION 5 M12
• Device Catalogue Number: 722227
• 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: 04/01/2026
• Initial Report FDA Received Date: 04/16/2026
• Date Device Manufactured: 05/09/2023
• 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
• Outcome Attributed to Adverse Event: Death
• Patient Age: 65 YR
• Patient Sex: Female