FDA Adverse Event
Malfunction
Summary report: N
LIFEVEST WCD 4000 SYSTEM
MDR report key: 23532354
·
Received November 12, 2025
Report
- Report Number
- 3008642652-2025-11000
- Event Type
- Malfunction
- Date Received
- November 12, 2025
- Date of Event
- November 11, 2025
- Report Date
- November 12, 2025
- Manufacturer
- ZOLL MANUFACTURING CORPORATION
- Product Code
- MVK
- UDI-DI
- 00855778005135
- 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 (ECGS NON-FUNCTIONAL) WAS CONFIRMED DUE TO ALL WIRES BEING BROKEN NEAR THE JST CONNECTOR OF ECG ¿C&D¿ CABLES. THE BELT DID NOT PASS FALLOFF TESTING. THE ROOT CAUSE FOR THE BROKEN WIRES WAS UNABLE TO BE POSITIVELY IDENTIFIED. THE ELECTRODE BELT IS DESIGNED TO MEET THE MECHANICAL REQUIREMENTS OF IEC 60601-1. THERE WAS NO ADVERSE EVENT THAT RESULTED FROM THE DAMAGED 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 |
|---|---|---|---|---|---|---|---|
| 2501887 | LIFEVEST WCD 4000 SYSTEM | WEARABLE CARDIOVERTER DEFIBRILLATOR | MVK | ZOLL MANUFACTURING CORPORATION | LIFEVEST WCD 4000 SYSTEM | 00855778005135 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |