FDA Adverse Event Malfunction Summary report: N

ZM-520PA

MDR report key: 10075969 · Received May 20, 2020

Report

Report Number
8030229-2020-00278
Event Type
Malfunction
Date Received
May 20, 2020
Date of Event
April 27, 2020
Report Date
November 16, 2021
Manufacturer
NIHON KOHDEN CORPORATION
Product Code
DRT
UDI-DI
04931921115077
PMA / PMN Number
K043517
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DETAILS OF COMPLAINT: THE BIOMEDICAL ENGINEER (BME) REPORTED THAT THE BATTERIES WERE HOT IN THE TELEMETRY TRANSMITTER. THEY REPLACED THE BATTERIES, BUT THE ISSUE PERSISTED. THEY REQUESTED THAT THE UNIT BE REPAIRED. NO PATIENT HARM WAS REPORTED. SERVICE REQUESTED / PERFORMED: EVALUATION / REPAIR: ON 05/05/2020, THE UNIT WAS CLEANED AND DECONTAMINATED BY NIHON KOHDEN AMERICA REPAIR CENTER (NKA RC). ON RC EVALUATION, THE REPORTED PROBLEM COULD NOT BE DUPLICATED. PHYSICAL DAMAGE TO THE FRONT CASE (HAIRLINE CRACK) WAS NOTICED, THE BATTERY CONTACT ON THE REAR CASE WAS CORRODED WITH RESIDUE FOUND ON THE CENTER CASE. ON 05/06/2020, THE FOLLOWING MALFUNCTIONING PARTS WERE RECOGNIZED AND REPLACED WHICH RESOLVED THE ISSUE: # 6142901448B FRONT CASE # CD-323P CENTER CASE #6142902693 REAR WITH BATTERY COVER # 6114918572A CASE SEALANT # 110168 O-RING # 6123906559 MAIN PANEL. THE UNIT WAS TESTED PER THE OPERATOR'S/SERVICE MANUAL AND THE RESULTS WERE RECORDED ON THE MAINTENANCE CHECK SHEET. THE UNIT COMPLETED 24 HOURS OF EXTENDED TESTING AND OPERATED TO THE MANUFACTURER'S SPECIFICATIONS. THE REPAIRED UNIT WAS SHIPPED BACK TO THE CUSTOMER ON 09/23/2020. NO ISSUES HAVE BEEN REPORTED SINCE. INVESTIGATION SUMMARY: THE NKC INVESTIGATION PERFORMED UNDER (B)(4) (A3-181170_FINAL-EG) CONCLUDED THAT INCORRECT INSERTION OF THE BATTERY MAY CAUSE THE BATTERY TERMINAL SPRING TO BREAK THE COATING OF THE BATTERY, LEADING TO A SHORT CIRCUIT. THE OVERALL RISK OF THIS EVENT IS MEDIUM. THE REPORTED ISSUE DOES NOT REQUIRE FURTHER INVESTIGATION THROUGH CAPA PROCESS SINCE THE ISSUE COULD NOT BE DUPLICATED ON NKA RC EVALUATION. HHA CONSIDERED THE PROBABILITY OF HARM AS "UNLIKELY OR REMOTE" IN SUCH REPORTED CASES. ALSO, A NEW DESIGN CHANGE WAS INTRODUCED TO THE TRANSMITTER'S REAR CASE WHICH WOULD ADD AN INSULATING SHEET TO PREVENT SHORT CIRCUIT OF THE BATTERY CAUSED BY INCORRECT BATTERY INSERTION. ADDITIONAL DEVICE INFORMATION: D10 CONCOMITANT MEDICAL DEVICE: THE FOLLOWING DEVICE(S) WERE USED IN CONJUNCTION WITH THE TRANSMITTER: CENTRAL NURSE'S STATION (CNS): MODEL #: CNS-6201A, SERIAL #: (B)(6) .

Description of Event or Problem · 0

THE BIOMEDICAL ENGINEER REPORTED THAT THE BATTERIES WERE HOT IN THE TELEMETRY TRANSMITTER. THEY REPLACED THE BATTERIES, BUT THE ISSUE PERSISTED. THEY REQUESTED THAT THE UNIT BE REPAIRED. NO PATIENT HARM WAS REPORTED.

Additional Manufacturer Narrative · 1

THE BIOMEDICAL ENGINEER REPORTED THAT THE BATTERIES WERE HOT IN THE TELEMETRY TRANSMITTER. THEY REPLACED THE BATTERIES AND THE ISSUE PERSISTS AND WOULD LIKE THE UNIT REPAIRED. NO PATIENT HARM WAS REPORTED. NIHON KOHDEN CONTINUES TO INVESTIGATE THE REPORTED EVENT. NIHON KOHDEN WILL SUBMIT A SUPPLEMENTAL REPORT IN ACCORDANCE WITH 21 CFR SECTION 803.56 WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE. ADDITIONAL DEVICE INFORMATION: CONCOMITANT MEDICAL DEVICE: THE FOLLOWING DEVICES WERE BEING USED IN CONJUNCTION WITH THE TELEMETRY TRANSMITTER. CENTRAL NURSE'S STATION: MODEL: CNS-6201A, SN: (B)(4).

Description of Event or Problem · 1

THE BIOMEDICAL ENGINEER REPORTED THAT THE BATTERIES WERE HOT IN THE TELEMETRY TRANSMITTER. THEY REPLACED THE BATTERIES AND THE ISSUE PERSISTS AND WOULD LIKE THE UNIT REPAIRED. NO PATIENT HARM WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
540606 ZM-520PA TRANSMITTER DRT NIHON KOHDEN CORPORATION ZM-520PA NA 04931921115077

Patients

Seq Age Sex Outcome Treatment
1 Unknown CNS-6201A SN (B)(6) | CNS-6201A SN (B)(6)