FDA Adverse Event Malfunction Summary report: N

PROPAQ MD DEFIBRILLATOR

MDR report key: 3040363 · Received March 12, 2013

Report

Report Number
1220908-2013-00705
Event Type
Malfunction
Date Received
March 12, 2013
Report Date
February 19, 2013
Manufacturer
ZOLL MEDICAL CORPORATION
Product Code
LDD
PMA / PMN Number
K100654
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ZOLL MEDICAL CORPORATION HAS RECEIVED THE PRODUCT AND WILL BE PROVIDING A FOLLOW-UP REPORT WHEN OUR INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

COMPLAINANT ALLEGED THAT DURING A ROUTINE SHIFT CHECK BY A CLINICIAN, THE DEVICE FAILED SELF-TEST. COMPLAINANT INDICATED THAT THERE WAS NO PT INVOLVEMENT IN THE REPORTED MALFUNCTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
104250 PROPAQ MD DEFIBRILLATOR DEFIBRILLATOR/PACEMAKER LDD ZOLL MEDICAL CORPORATION PROPAQ MD NA

Patients

Seq Age Sex Outcome Treatment
1 NA