FDA Adverse Event Malfunction Summary report: N

LIFEPAK 20 DEFIBRILLATOR/MONITOR

MDR report key: 1193139 · Received October 7, 2008

Report

Report Number
3015876-2008-01459
Event Type
Malfunction
Date Received
October 7, 2008
Date of Event
September 5, 2008
Report Date
September 7, 2008
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
LDD
PMA / PMN Number
K012274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, 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 OF THE REPORTED FAILURE WAS AN ELECTRICAL SHORT THROUGH FET TRANSISTORS, DESIGNATORS Q1 AND Q2. IT WAS ALSO OBSERVED THAT A FUSE, DESIGNATOR F1, WAS OPEN.

Description of Event or Problem · 1

IT WAS REPORTED THE DEVICE WOULD NOT OPERATE ON AC POWER. THERE WAS NO PATIENT 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