FDA Adverse Event Malfunction Summary report: N

UNI-VENT, MODEL 731

MDR report key: 10883924 · Received November 23, 2020

Report

Report Number
1220908-2020-03832
Event Type
Malfunction
Date Received
November 23, 2020
Report Date
November 6, 2020
Manufacturer
ZOLL MEDICAL CORPORATION
Product Code
CBK
PMA / PMN Number
K111473
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UZ
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THE CUSTOMER WAS CONTACTED FOR RETURN OF THE SUSPECT PRODUCT. THE PRODUCT HAS NOT BEEN RETURNED TO ZOLL FOR EVALUATION.

Additional Manufacturer Narrative · 0

THE DEVICE WAS RETURNED TO ZOLL MEDICAL CORPORATION FOR EVALUATION. THE CUSTOMER'S REPORT WAS OBSERVED AND AN INTERNAL INSPECTION CONFIRMED DEBRIS INSIDE THE TRANSDUCER FLOW SCREENS. ALL TRANSDUCER SCREENS WERE REPLACED TO RESOLVE THE REPORT. THE DEVICE WAS RECERTIFIED AND RETURNED TO THE CUSTOMER. ANALYSIS OF REPORTS OF THIS TYPE HAS NOT IDENTIFIED AN INCREASE IN TREND.

Additional Manufacturer Narrative · 1

ZOLL MEDICAL CORPORATION HAS NOT RECEIVED THE DEVICE FOR EVALUATION AND THIS COMPLAINT IS STILL UNDER INVESTIGATION.

Description of Event or Problem · 1

COMPLAINANT ALLEGED THAT WHILE ATTEMPTING TO TREAT A PATIENT (AGE & GENDER UNKNOWN), THE DEVICE DISPLAYED "COMPRESSOR FAILURE -1001" AND "SELF CHECK FAILURE -1003" MESSAGES. COMPLAINANT INDICATED THAT THE CLINICIAN OBTAINED ANOTHER DEVICE TO CONTINUE TREATING THE PATIENT. COMPLAINANT DID NOT INDICATE THAT THERE WAS ANY ADVERSE EFFECT TO THE PATIENT DUE TO THE REPORTED MALFUNCTION. PLEASE REFERENCE MEDWATCH REPORT 1220908-2020-03830, 1220908-2020-03831, 1220908-2020-03792, 1220908-2020-03833, 1220908-2020-03834, 1220908-2020-03793, 1220908-2020-03835, 1220908-2020-03836, 1220908-2020-038320, 1220908-2020-03837, AND 1220908-2020-03838 FOR SIMILAR EVENTS REPORTED FROM THE SAME CUSTOMER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1351073 UNI-VENT, MODEL 731 VENTILATOR CBK ZOLL MEDICAL CORPORATION 799-EMVP-01-05 NA

Patients

Seq Age Sex Outcome Treatment
1 Unknown