FDA Adverse Event Malfunction Summary report: N

LIFEPAK 20 DEFIBRILLATOR/MONITOR

MDR report key: 1232117 · Received November 4, 2008

Report

Report Number
3015876-2008-01581
Event Type
Malfunction
Date Received
November 4, 2008
Date of Event
October 7, 2008
Report Date
October 7, 2008
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
LDD
PMA / PMN Number
K012274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PHYSIO-CONTROL SUPPLIED PARTS INFORMATION TO CUSTOMER FOR REPLACEMENT. PROCESS CHANGES HAVE BEEN IMPLEMENTED TO INCREASE THE AMOUNT OF ADHESIVE TO THE ELECTRODE PLATE.

Description of Event or Problem · 1

CUSTOMER REPORTED A SET OF PADDLES WHERE THE ADULT ACCESSORY PORTION OF THE PADDLE IS COMING LOOSE AT THE ELECTRODE PLATE. THERE WAS NO PATIENT ASSOCIATED WITH THE REPORT.

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 STANDARD HARD PADDLE SET FOR THE| LIFEPAK 20 DEFIBRILLATOR