| Brand Name | PageWriter |
| Common Device Name | Electrocardiograph |
| Manufacturer (Section D) |
| Philips Medical Systems |
| 3000 minuteman rd |
| andover MA 01810 |
|
| Manufacturer (Section G) |
| Philips Medical Systems |
| 3000 minuteman rd |
|
| andover MA 01810 |
|
| Manufacturer Contact |
|
deborah
currlin
|
| 3000 minuteman rd |
| andover, MA 01810
|
|
+1(617)245-5900
|
|
| MDR Report Key | 50123109 |
| Report Number | 1218950-2026-100532 |
| Device Sequence Number | 13393827 |
| Product Code |
DPS
|
| UDI-Device Identifier | 00884838028784 |
| UDI-Public | (01)00884838028784 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | IN |
| PMA/510(K) Number | K113144 |
| 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 |
Biomedical Engineer
|
| Type of Report
| Initial |
| Report Date (Section B) |
08/03/2026 |
| 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 | PageWriter TC20 Cardiograph |
| Device Catalogue Number | 860332 |
| Was Device Available for Evaluation? |
Yes
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 07/09/2026 |
| Initial Report FDA Received Date | 08/03/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 10/13/2023 |
| 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 |
| Patient Sex | Unknown |
|
|