FDA Adverse Event
Malfunction
Summary report: N
LIFEVEST WCD 4000 SYSTEM
MDR report key: 23245181
·
Received October 8, 2025
Report
- Report Number
- 3008642652-2025-09693
- Event Type
- Malfunction
- Date Received
- October 8, 2025
- Date of Event
- October 6, 2025
- Report Date
- October 8, 2025
- Manufacturer
- ZOLL MANUFACTURING CORPORATION
- Product Code
- MVK
- PMA / PMN Number
- P010030
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
DEVICE EVALUATION OF ELECTRODE BELT HAS BEEN COMPLETED. THE REPORTED PROBLEM (NON-FUNCTIONAL ECGS) HAS BEEN CONFIRMED. UPON INVESTIGATION THE ELECTRODE BELT FAILED AN ECG FALL-OFF TEST. THIS FAILURE WAS DUE TO THE LEAD 1- WIRE BROKEN NEAR THE JST CONNECTOR ON THE ECG C AND D CABLE. THE ROOT CAUSE FOR THE BROKEN WIRES COULD NOT BE POSITIVELY IDENTIFIED. THERE WERE NO ADVERSE EVENTS ASSOCIATED WITH THE DAMAGED ELECTRODE BELT.
Description of Event or Problem · 0
A US DISTRIBUTOR REPORTED THAT AN ELECTRODE BELT HAD NON-FUNCTIONAL ECGS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2584161 | LIFEVEST WCD 4000 SYSTEM | WEARABLE CARDIOVERTER DEFIBRILLATOR | MVK | ZOLL MANUFACTURING CORPORATION | LIFEVEST WCD 4000 SYSTEM |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |