BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LIFE PAK

    MDR report key: 110403 · Received July 30, 1997

    Report

    Report Number
    MW4001900
    Event Type
    Injury
    Date Received
    July 30, 1997
    Date of Event
    July 8, 1997
    Report Date
    July 25, 1997
    Manufacturer
    PHYSIO-CONTROL CORP.
    Product Code
    LDD
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    RPTR RECENTLY SUBMITTED A VOLUNTARY MEDWATCH REPORT, DATED 7/25/1997, WITH A COPY TO THE MFR. SINCE THEN RPTR HAS DISCOVERED THAT THE SERIAL NUMBER ON THE REPORT WAS INCORRECT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIFE PAK DEFIBRILLATOR LDD PHYSIO-CONTROL CORP. LP-6D *

    Patients

    Seq Age Sex Outcome Treatment
    1 6 MO Required Intervention