FDA Adverse Event
Malfunction
Summary report: N
LIFEVEST WCD 4000 SYSTEM
MDR report key: 4321223
·
Received December 2, 2014
Report
- Report Number
- 3008642652-2014-04612
- Event Type
- Malfunction
- Date Received
- December 2, 2014
- Date of Event
- November 4, 2014
- Report Date
- December 1, 2014
- Manufacturer
- ZOLL MANUFACTURING CORP
- Product Code
- MVK
- PMA / PMN Number
- P010030
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
DEVICE EVALUATION OF BATTERY SN (B)(4) IS COMPLETE. THE REPORTED PROBLEM (BATTERY WON'T POWER MONITOR) WAS CONFIRMED. AS RECEIVED, THE BATTERY WOULD NOT CHARGER OR POWER ON A MONITOR. UPON EVALUATION THE BATTERY CELL VOLTAGES WERE MIS-MATCHED AT 4.238V, -1.89SV, AND 4.241V. THE CAUSE FOR THE INABILITY TO CHARGE IN A CHARGER OR POWER ON A MONITOR IS THE MIS-MATCHED CELLS. THE ROOT CAUSE OF THE MIS-MATCHED CELLS WAS UNABLE TO BE POSITIVELY IDENTIFIED. NO ADVERSE EVENT RESULTED FORM THE DEFECTIVE BATTERY PACK.
Description of Event or Problem · 1
A ZOLL DISTRIBUTOR CONTACTED ZOLL TO REPORT THAT BATTERY SN (B)(4) WOULD NOT POWER ON A MONITOR.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 777043 | LIFEVEST WCD 4000 SYSTEM | WEARABLE CARDIOVERTER DEFIBRILLATOR | MVK | ZOLL MANUFACTURING CORP | WCD 4000 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA |