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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZOLL MANUFACTURING CORPORATION LIFEVEST WCD 4000 SYSTEM; WEARABLE CARDIOVERTER DEFIBRILLATOR

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ZOLL MANUFACTURING CORPORATION LIFEVEST WCD 4000 SYSTEM; WEARABLE CARDIOVERTER DEFIBRILLATOR Back to Search Results
Model Number WCD 4000
Device Problem Patient-Device Incompatibility (2682)
Patient Problems Itching Sensation (1943); Skin Discoloration (2074); Skin Irritation (2076); Reaction (2414)
Event Date 07/13/2020
Event Type  Injury  
Manufacturer Narrative
Biocompatibility testing to iso 10993 was successfully completed on skin-contacting surfaces of the lifevest device as well as the blue¿ defibrillation gel.
 
Event Description
A us distributor contacted zoll to report that a patient developed a skin irritation.The irritation was described as darkened, red, itchy, and appears as bumps.The patient stated the irritation appeared as a skin reaction.The patient reported to be taking blood thinners.The patient confirmed she has a history of sensitive skin and is allergic to different metals.There was no alleged device malfunction contributing to the irritation.Patient was seen by a physician.The patient initially used calamine lotion on her own, but then was prescribed flonase by a medical professional.The patient also used benadryl but its unclear if this was prescribed by the physician.The outcome is unknown as the patient stated she would speak with her doctor.
 
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Brand Name
LIFEVEST WCD 4000 SYSTEM
Type of Device
WEARABLE CARDIOVERTER DEFIBRILLATOR
Manufacturer (Section D)
ZOLL MANUFACTURING CORPORATION
121 gamma drive
pittsburgh, pa
Manufacturer (Section G)
ZOLL MANUFACTURING CORPORATION
121 gamma drive
pittsburgh, pa
Manufacturer Contact
kevin chan
121 gamma drive
pittsburgh, pa 
9683333
MDR Report Key10378181
MDR Text Key202005805
Report Number3008642652-2020-06685
Device Sequence Number1
Product Code MVK
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P010030
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type distributor
Reporter Occupation Other
Type of Report Initial
Report Date 08/03/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/07/2020
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Lay User/Patient
Device Model NumberWCD 4000
Was Device Available for Evaluation? No
Date Manufacturer Received07/28/2020
Was Device Evaluated by Manufacturer? Yes
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
Patient Outcome(s) Other; Required Intervention;
Patient Age70 YR
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