FDA Adverse Event Malfunction Summary report: N

LIFEPAK 20 DEFIBRILLATOR/MONITOR

MDR report key: 1071856 · Received July 8, 2008

Report

Report Number
3015876-2008-00769
Event Type
Malfunction
Date Received
July 8, 2008
Date of Event
January 30, 2008
Report Date
January 30, 2008
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
LDD
PMA / PMN Number
K012274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PHYSIO-CONTROL EVALUATED THE DEVICE AND OBSERVED THAT IT WOULD NOT OPERATE ON AC POWER. THE SERVICE REP 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 POWER SUPPLY ASSEMBLY AND DETERMINED THAT ROOT CAUSE FOR THE REPORTED INCIDENT WAS AN ELECTRICAL SHORT THROUGH 2 FET TRANSISTORS, DESIGNATORS Q1 AND Q2.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE AC MAINS LED IS NOT ILLUMINATED WHEN PLUGGED INTO AC POWER AND THE AC LOSS ALERT IS SOUNDING. NO PT WAS 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