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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Philips North America LLC HeartStart; Over-The-Counter Automated External Defibrillator

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Philips North America LLC HeartStart; Over-The-Counter Automated External Defibrillator Back to Search Results
Model Number HeartStart HS1
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 is failing self-test.
 
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Brand Name
HeartStart
Common Device Name
Over-The-Counter Automated External Defibrillator
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
maria heiling
22100 bothell everett highway
bothell, WA 98021
+1(909)570-3538
MDR Report Key50853100
Report Number3030677-2026-101016
Device Sequence Number18518595
Product Code NSA
UDI-Device Identifier00884838075849
UDI-Public(01)00884838075849
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
P160029
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Type of Report Initial
Report Date (Section B) 09/22/2026
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
Device Model NumberHeartStart HS1
Device Catalogue NumberM5066A
Device Lot Number35325
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 09/17/2026
Initial Report FDA Received Date09/22/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured10/01/2018
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
Patient Sequence Number1
Patient SexUnknown
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