BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LIFEVEST WCD 3000 SYSTEM

    MDR report key: 1061082 · Received June 13, 2008

    Report

    Report Number
    3002158293-2008-00259
    Event Type
    Malfunction
    Date Received
    June 13, 2008
    Date of Event
    May 29, 2008
    Report Date
    June 12, 2008
    Manufacturer
    ZOLL LIFECOR CORPORATION
    Product Code
    MVK
    PMA / PMN Number
    P010030
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    DEVICE EVAL SUMMARY: DEVICE EVAL OF ELECTRODE BELT HAS BEEN COMPLETED. THE ELECTRODE BELT HAS FOUND TO HAVE AN OPEN CONNECTION IN THE DISTRIBUTION NODE. THE DISTRIBUTION NODE WAS REPAIRED AND THE ELECTRODE BELT WAS TESTED. BASELINE EVAL WAS PERFORMED AND THE CARDIAC SIGNAL NOW APPEARS NORMAL. THE ELECTRODE BELT WAS RETURNED TO STOCK. THE ROOT CAUSE OF THIS OPEN CONNECTION IS UNK BUT IS LIKELY DUE TO STRAIN PLACED ON THE CABLE DURING PT USE. NO ADVERSE EVENT RESULTED FROM THE FAULTY ELECTRODE BELT.

    Description of Event or Problem · 1

    A REVIEW OF SERVICE DATA DETECTED A REPORTABLE EVENT. DURING SERVICING OF ELECTRODE BELT, WHICH WAS RETURNED FOR ROUTINE MAINTENANCE, IT WAS DISCOVERED THAT ELECTRODE BELT HAD AN OPEN CONNECTION IN THE DISTRIBUTION NODE. THE LAST PT TO USE THIS ELECTRODE BELT DID NOT REPORT ANY PROBLEMS WITH IT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIFEVEST WCD 3000 SYSTEM WEARABLE CARDIOVERTER DEFIBRILLATOR MVK ZOLL LIFECOR CORPORATION WCD 3000 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NA