FDA Adverse Event Malfunction Summary report: N

LIFEPAK 12 DEFIBRILLATOR/MONITOR SERIES

MDR report key: 1032282 · Received April 21, 2008

Report

Report Number
3015876-2008-00367
Event Type
Malfunction
Date Received
April 21, 2008
Date of Event
March 24, 2008
Report Date
March 24, 2008
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
MKJ
PMA / PMN Number
K991910
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

PHYSIO-CONTROL EVALUATED THE DEVICE AND VERIFIED THE REPORTED FAILURE. PHYSIO REPLACED THE MAIN CONTROL KEYPAD ASSEMBLY AND THEN OBSERVED PROPER DEVICE OPERATION THROUGH FUNCTIONAL AND PERFORMANCE TESTING. THE DEVICE WAS RETURNED TO THE CUSTOMER FOR USE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WOULD NOT POWER ON. THERE WAS NO PATIENT USE ASSOCIATED WITH THE REPORTED EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIFEPAK 12 DEFIBRILLATOR/MONITOR SERIES MKJ PHYSIO-CONTROL, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA