FDA Adverse Event Malfunction Summary report: N

LIFEPAK 20 DEFIBRILLATOR/MONITOR

MDR report key: 1191393 · Received September 26, 2008

Report

Report Number
3015876-2008-01418
Event Type
Malfunction
Date Received
September 26, 2008
Date of Event
August 29, 2008
Report Date
August 29, 2008
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
LDD
PMA / PMN Number
K012274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PHYSIO-CONTROL EVALUATED THE DEVICE AND OBSERVED THAT IT WOULD NOT POWER ON. PHYSIO REPLACED THE SYSTEM 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

IT WAS REPORTED THAT THE DEVICE WOULD NOT POWER ON WITH DC OR AC POWER. NO PATIENT WAS INVOLVED WITH 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