FDA Adverse Event Malfunction Summary report: N

LIFEPAK 20 DEFIBRILLATOR/MONITOR

MDR report key: 1082012 · Received July 22, 2008

Report

Report Number
3015876-2008-00814
Event Type
Malfunction
Date Received
July 22, 2008
Date of Event
June 23, 2008
Report Date
June 23, 2008
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
LDD
PMA / PMN Number
K012274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

PHYSIO-CONTROL EVALUATED THE DEVICE AND VERIFIED THE REPORTED FAILURE. PHYSIO 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-CONTROL FURTHER EVALUATED THE REPLACED ASSEMBLY AND DETERMINED THAT THE ROOT CAUSE FOR THE REPORTED FAILURE WAS AN ELECTRICAL SHORT THROUGH FET TRANSISTOR DESIGNATOR Q6. IT WAS ALSO OBSERVED THAT A FUSE, DESIGNATOR F1, WAS OPENED.

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 THIS 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