FDA Adverse Event Malfunction Summary report: N

LIFEPAK 20 DEFIBRILLATOR/MONITOR

MDR report key: 1012861 · Received March 12, 2008

Report

Report Number
3015876-2008-00173
Event Type
Malfunction
Date Received
March 12, 2008
Date of Event
February 4, 2008
Report Date
February 15, 2008
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
LDD
PMA / PMN Number
K012274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

PHYSIO-CONTRL EVALUATED THE DEVICE AND OBSERVED THAT IT WOULD NOT OPERATE ON AC POWER. PHYSIO REPLACED THE POWER SUPPLY 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 EVENT WAS ELECTRICALLY SHORTED FET TRANSISTORS, DESIGNATORS Q1 AND Q2.

Description of Event or Problem · 1

FOUND DURING TESTING. ACCORDING TO THE REPORTER, THE DEVICE WOULD NOT OPERATE ON AC POWER. THERE WAS NO PT 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