FDA Adverse Event Injury Summary report: N

HWD 1000 SYSTEM

MDR report key: 15164015 · Received August 4, 2022

Report

Report Number
3008642652-2022-21782
Event Type
Injury
Date Received
August 4, 2022
Date of Event
July 30, 2022
Report Date
August 4, 2022
Manufacturer
ZOLL MANUFACTURING CORPORATION
Product Code
MVK
PMA / PMN Number
P010030
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

THE MONITOR AND ELECTRODE BELT HAVE NOT BEEN RETURNED FOR EVALUATION. BASED ON THE DATA AVAILABLE AT THIS TIME, THERE IS NO INDICATION OF A DEVICE MALFUNCTION CAUSING OR CONTRIBUTING TO THE INAPPROPRIATE TREATMENT. INAPPROPRIATE DEFIBRILLATIONS ARE AN ANTICIPATED RISK ASSOCIATED WITH THE USE OF THE LIFEVEST. PATIENTS ARE INSTRUCTED THROUGH ALARMS, VOICE MESSAGES, IFU, AND TRAINING TO PRESS THE RESPONSE BUTTONS TO PREVENT AN INAPPROPRIATE DEFIBRILLATION. THE CURRENT COMMERCIAL INAPPROPRIATE DEFIBRILLATION RATE IS CONSISTENT WITH THE OBSERVED RATE DURING THE PIVOTAL CLINICAL TRIAL G960083 (0.69% PER PATIENT-MONTH WITH 90% CONFIDENCE). A SUMMARY OF THE SAFETY AND EFFECTIVENESS DATA (SSED), INCLUDING THE INAPPROPRIATE DEFIBRILLATION SAFETY OBJECTIVE SUPPORTING FDA'S APPROVAL OF THE LIFEVEST, CAN BE FOUND AT HTTP://WWW.ACCESSDATA.FDA.GOV/CDRH_DOCS/PDF/P010030B.PDF. THE LIFEVEST DETECTION ALGORITHM COMPLIES WITH IEC 60601-2-4 PERFORMANCE REQUIREMENTS FOR SENSITIVITY AND SPECIFICITY.

Description of Event or Problem · 0

THE PATIENT WAS INAPPROPRIATELY TREATED 1 TIME BY THE HOSPITAL WEARABLE DEFIBRILLATOR (HWD). THE PATIENT'S NEUROLOGICAL STATUS AT THE TIME OF THE EVENT IS UNKNOWN. MULTIPLE COUNTING OF THE ECG SIGNAL AND MOTION ARTIFACT CONTRIBUTED TO THE FALSE DETECTION. THE RESPONSE BUTTONS WERE NOT PRESSED DURING THE EVENT. NO INJURY WAS REPORTED FROM THE TREATMENT. IT IS UNKNOWN IF THE PATIENT SOUGHT MEDICAL ATTENTION. NO DEFICIENCIES WERE ALLEGED AGAINST THE DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2773023 HWD 1000 SYSTEM WEARABLE CARDIOVERTER DEFIBRILLATOR MVK ZOLL MANUFACTURING CORPORATION HWD 1000 SYSTEM

Patients

Seq Age Sex Outcome Treatment
1 Unknown