Brand Name | HANDLES AND CONNECTOR WITH DISCHARGE CONTROL |
Type of Device | DC-DEFIBRILLATOR, LOW-ENERGY, (INCLUDING PADDLES) |
Manufacturer (Section D) |
PHYSIO-CONTROL, INC |
11811 willows road ne |
redmond WA 98073 9706 |
|
Manufacturer (Section G) |
PHYSIO-CONTROL, INC |
11811 willows road ne |
|
redmond WA 98073 9706 |
|
Manufacturer Contact |
|
MDR Report Key | 6681912 |
MDR Text Key | 79123591 |
Report Number | 3015876-2017-00816 |
Device Sequence Number | 1 |
Product Code |
LDD
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K895379 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,health |
Reporter Occupation |
Nurse
|
Type of Report
| Initial |
Report Date |
06/30/2017 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Catalogue Number | 3010901-007 |
Device Lot Number | 1208 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 06/20/2017 |
Is the Reporter a Health Professional? |
Yes
|
Device Age | 5 YR |
Event Location |
Hospital
|
Initial Date Manufacturer Received |
06/05/2017
|
Initial Date FDA Received | 06/30/2017 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Reuse
|
Patient Sequence Number | 1 |