FDA Adverse Event Malfunction Summary report: N

LIFEVEST WCD 3000 SYSTEM

MDR report key: 1172627 · Received September 19, 2008

Report

Report Number
3002158293-2008-00461
Event Type
Malfunction
Date Received
September 19, 2008
Date of Event
August 31, 2008
Report Date
September 18, 2008
Manufacturer
ZOLL LIFECOR CORPORATION
Product Code
MVK
PMA / PMN Number
P010030
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

DEVICE EVALUATION SUMMARY: DEVICE EVALUATION OF BATTERY PACK HAS BEEN COMPLETED. THE REPORTED PROBLEM WAS CONFIRMED. THE CAUSE OF THE BAD BATTERY LED WAS A BLOWN FUSE WITHIN THE BATTERY PACK. THE ROOT CAUSE OF THE BLOWN FUSE IS NOT KNOWN, BUT WAS LIKELY RANDOM COMPONENT FAILURE. THE BLOWN FUSE WAS REPLACED. THE BATTERY PACK WAS RETESTED AND RESTOCKED. NO ADVERSE EVENT RESULTED FROM THE FAULTY BATTERY PACK. THE PATIENT RECEIVED A REPLACEMENT BATTERY PACK.

Description of Event or Problem · 1

A MALE PATIENT CONTACTED LIFECOR CUSTOMER SUPPORT TO REPORT THAT ONE OF HIS BATTERY PACKS WOULD NOT START UP THE MONITOR. HE STATED THAT WHEN THIS BATTERY PACK WAS PLACED IN THE BATTERY CHARGER THE RED BLINKING BAD BATTERY LED ILLUMINATED. SUPPORT SENT A PATIENT SERVICES REPRESENTATIVE (PSR) TO THE PATIENT TO REPLACE THE BATTERY PACK.

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 77 YR