FDA Adverse Event Malfunction Summary report: N

LIFEPAK 20 DEFIBRILLATOR/MONITOR

MDR report key: 1021541 · Received March 26, 2008

Report

Report Number
3015876-2008-00231
Event Type
Malfunction
Date Received
March 26, 2008
Date of Event
February 26, 2008
Report Date
February 26, 2008
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
LDD
PMA / PMN Number
K012274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PHYSIO-CONTROL EVALUATED THE DEVICE. THE REPORTED PROBLEM WAS VERIFIED. THE ROOT CAUSE WAS DETERMINED TO BE DUE TO A FAILURE OF THE POWER SUPPLY ASSEMBLY. THE POWER SUPPLY ASSEMBLY WILL BE REPLACED AND THE DEVICE WILL BE RETURNED TO THE CUSTOMER.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WOULD NOT OPERATE ON AC POWER. THERE WAS NO PT USE ASSOCIATED WITH THE REPORTED 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