FDA Adverse Event Malfunction Summary report: N

LIFEPAK 9P DEFIBRILLATOR/MONITOR/PACEMAKER

MDR report key: 2182101 · Received June 23, 2011

Report

Report Number
3015876-2011-00491
Event Type
Malfunction
Date Received
June 23, 2011
Date of Event
May 25, 2011
Report Date
May 25, 2011
Manufacturer
PHYSIO-CONTROL, INC.
Product Code
LDD
PMA / PMN Number
K902288
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

(B)(4): PHYSIO-CONTROL PROVIDED TECHNICAL ASSISTANCE TO THE CUSTOMER, RECOMMENDED REPLACEMENT OF THE POWER CONVERSION PCB ASSEMBLY, AND PROVIDED THE NECESSARY PART NUMBER FOR THE PCB ASSEMBLY. THE DEVICE WILL NOT BE RETURNED TO PHYSIO-CONTROL FOR EVALUATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WOULD GIVE A FAULT MESSAGE ON THE SCREEN WHEN TRYING TO CHARGE FOR DEFIBRILLATION THERAPY. WHEN THE MESSAGE APPEARED, THE DEVICE WOULD NOT CHARGE FOR DEFIBRILLATION THERAPY. THERE WAS NO PT USE ASSOCIATED WITH THE REPORTED FAILURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIFEPAK 9P DEFIBRILLATOR/MONITOR/PACEMAKER LDD PHYSIO-CONTROL, INC. 9P NA

Patients

Seq Age Sex Outcome Treatment
1 NA