FDA Adverse Event Malfunction Summary report: N

LIFEPAK 20 DEFIBRILLATOR/MONITOR

MDR report key: 1011944 · Received March 11, 2008

Report

Report Number
3015876-2008-00166
Event Type
Malfunction
Date Received
March 11, 2008
Date of Event
February 8, 2008
Report Date
February 13, 2008
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
LDD
PMA / PMN Number
K012274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PHYSIO-CONTROL EVALUATED THE DEVICE AND OBSERVED THAT IT WOULD NOT POWER UP ON AC POWER OR IN BATTERY. PHYSIO REPLACED THE THERAPY PCB ASSEMBLY AND THEN OBSERVED PROPER DEVICE OPERATION THROUGH FUNCTIONAL AND PERFORMANCE TESTING. THE DEVICE WAS RETURNED TO THE CUSTOMER FOR USE. PHYSIO FURTHER EVALUATED THE REPLACED ASSEMBLY AND DETERMINED THAT ROOT CAUSE FOR THE REPORTED INCIDENT WAS AN IC CHIP, DESIGNATOR U18.

Description of Event or Problem · 1

FOUND DURING TESTING. ACCORDING TO THE REPORTER, THE DEVICE WOULD NOT POWER UP. THERE WAS NO PATIENT INVOLVEMENT REPORTED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIFEPAK 20 DEFIBRILLATOR/MONITOR LDD PHYSIO-CONTROL, INC. 20 NA

Patients

Seq Age Sex Outcome Treatment
1 NA