FDA Adverse Event Malfunction Summary report: N

LIFEVEST WCD 3000 SYSTEM

MDR report key: 2140303 · Received June 15, 2011

Report

Report Number
3008642652-2011-00059
Event Type
Malfunction
Date Received
June 15, 2011
Date of Event
May 15, 2011
Report Date
June 15, 2011
Manufacturer
ZOLL LIFECOR CORPORATION
Product Code
MVK
PMA / PMN Number
P010030
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

DEVICE EVALUATION SUMMARY: DEVICE EVALUATION OF BATTERY PACK SN (B)(4) HAS BEEN COMPLETED. THE REPORTED PROBLEM (BATTERY WON'T HOLD CHARGE) HAS BEEN CONFIRMED. UPON EVALUATION, THE BATTERY OUTPUT VOLTAGE WAS MEASURED AT 6 VOLTS. THE CAUSE FOR THE LOW OUTPUT VOLTAGE CANNOT BE POSITIVELY DETERMINED BUT WAS LIKELY THE RESULT OF DEFECTIVE CELLS. NO ADVERSE EVENT RESULTED FROM THE DEFECTIVE BATTERY PACK. THE PATIENT RECEIVED A REPLACEMENT BATTERY PACK.

Description of Event or Problem · 1

THE WIFE OF AN (B)(6) MALE PATIENT CONTACTED ZOLL CUSTOMER SUPPORT TO REPORT THAT HIS BATTERY PRODUCES A "BATTERY PROBLEM" MESSAGE WHEN PLACED ON THE CHARGER. THE PATIENT WAS ISSUED A REPLACEMENT 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 43 YR