FDA Adverse Event Malfunction Summary report: N

PROPAQ MD DEFIBRILLATOR

MDR report key: 3132317 · Received May 1, 2013

Report

Report Number
1220908-2013-01039
Event Type
Malfunction
Date Received
May 1, 2013
Report Date
April 11, 2013
Manufacturer
ZOLL MEDICAL CORPORATION
Product Code
MKJ
PMA / PMN Number
K100654
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ZOLL MEDICAL CORP HAS RECEIVED THE PRODUCT AND WILL BE PROVIDING A F/U 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 FOR DEFIB AND PACER. COMPLAINANT INDICATED THAT THERE WAS NO PT INVOLVEMENT IN THE REPORTED MALFUNCTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
190950 PROPAQ MD DEFIBRILLATOR DEFIBRILLATOR/PACEMAKER MKJ ZOLL MEDICAL CORPORATION PROPAQ MD NA

Patients

Seq Age Sex Outcome Treatment
1 NA