FDA Adverse Event Malfunction Summary report: N

LIFEPAK 20 DEFIBRILLATOR/MONITOR

MDR report key: 1070673 · Received July 2, 2008

Report

Report Number
3015876-2008-00731
Event Type
Malfunction
Date Received
July 2, 2008
Date of Event
June 3, 2008
Report Date
June 3, 2008
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
LDD
PMA / PMN Number
K012274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MS, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PHYSIO-CONTROL EVALUATED THE DEVICE AND OBSERVED THAT THE DEVICE WOULD FAIL THE USER TEST, ILLUMINATE THE SERVICE LED AND LOG FAULT CODES IN THE ERROR LOG OF DEVICE MEMORY RELATED TO INCORRECT ENERGY LEVELS. 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.

Description of Event or Problem · 1

ACCORDING TO THE REPORTER, THE DEVICE IS FAILING USER TEST AND SELF TEST CONSISTENTLY AND THE SERVICE INDICATOR IS ILLUMINATED. THERE WAS NO PATIENT ASSOCIATED WITH THE REPORTED INCIDENT.

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