Brand Name | MX40 2.4 GHZ SMART HOPPING |
Type of Device | MX40 2.4 GHZ SMART HOPPING |
Manufacturer (Section D) |
PHILIPS MEDICAL SYSTEMS |
3000 minuteman road |
andover MA 01810 |
|
Manufacturer Contact |
richa
shah
|
3000 minuteman road |
andover, MA 01810
|
9786871501
|
|
MDR Report Key | 6654267 |
MDR Text Key | 78130104 |
Report Number | 1218950-2017-04165 |
Device Sequence Number | 1 |
Product Code |
DSI
|
Combination Product (y/n) | N |
Reporter Country Code | AS |
PMA/PMN Number | K113125 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
foreign,user facility |
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup |
Report Date |
06/07/2017 |
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 Operator |
Health Professional
|
Device Model Number | 865351 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 05/30/2017 |
Is the Reporter a Health Professional? |
No
|
Was the Report Sent to FDA? |
No
|
Initial Date Manufacturer Received |
06/07/2017 |
Initial Date FDA Received | 06/20/2017 |
Supplement Dates Manufacturer Received | 06/07/2017
|
Supplement Dates FDA Received | 09/12/2017
|
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 06/14/2013 |
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Reuse
|
Patient Sequence Number | 1 |
|
|