FDA Adverse Event Death Summary report: N

GS

MDR report key: 15984946 · Received December 15, 2022

Report

Report Number
8020045-2022-00031
Event Type
Death
Date Received
December 15, 2022
Date of Event
November 8, 2022
Report Date
January 23, 2023
Manufacturer
LEONHARD LANG GMBH
Product Code
MKJ
UDI-DI
19005531505302
PMA / PMN Number
NONE
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

RETAINED SAMPLES OF THE CONCERNED LOT NUMBER (211108-3996) HAVE BEEN INSPECTED VISUALLY AND TESTED ELECTRICALLY FOR THE FUNCTION. ALL TESTED ELECTRODES WERE WITHIN LIMITS, NO FAILURE COULD BE DETECTED. ON (B)(6) 2022 THE INVOLVED DEVICE WAS RECEIVED IN AN OPEN POUCH. IT WAS DISINFECTED AND THEN INSPECTED. A VISUAL INSPECTION OF THE DEFIBRILLATION ELECTRODE SET SHOWED NO OBVIOUS DAMAGE. THE CONNECTOR OF THE INVOLVED ELECTRODE SET WAS ALSO VISUALLY INSPECTED. NEITHER DAMAGES NOR DEVIATIONS WERE VISIBLE. AN ELECTRICAL CONTINUITY TEST WAS PERFORMED USING A MULTIMETER TO TEST FOR ELECTRICAL CONTINUITY. THE CONTINUITY TEST WAS PERFORMED TO CHECK THE ELECTRICAL CONTINUITY BETWEEN THE CONNECTOR (PIN APEX AND STERNUM PAD) AND THE ELECTRODE (GEL AREA OF APEX AND STERNUM ELECTRODE). THE CONTINUITY TEST WAS WITHIN LIMITS. AS NO VISUAL AND NO ELECTRICAL CONTINUITY FAILURE COULD BE DETECTED AN ELECTRICAL PERFORMANCE TEST WAS CARRIED ON. THE INVOLVED ELECTRODE SETS WAS ADHERED ONTO THE DEFIBRILLATION TEST EQUIPMENT FLUKE IMPULSE 7000DP AND CONNECTED TO THE GS CORPULS DEFIBRILLATOR. THE DEFIBRILLATOR WAS SWITCHED ON AND THE PADS WORKED PROPERLY - IMMEDIATELY AN ECG SIGNAL WAS VISIBLE ON THE DISPLAY. WE HAVE SIMULATED A VENTRICULAR FIBRILLATION AND HAVE SUCCESSFULLY SHOCKED TO THE DEFIBRILLATION TEST EQUIPMENT FLUKE IMPULSE 7000DP. ON DECEMBER 5TH WE HAVE RECEIVED AN EXCERPT OF THE DATA THE DEFIBRILATOR HAD RECORDED DURING THE PROCEDURE. THE DATA PROVIDED SHOW NO CLEAR ROOT CAUSE FOR THE CLAIMED FAILURE. WE THEREFORE WILL FURTHER INVESTIGATE THE INVOLVED DEFIBRILLATION ELECTRODESET AT UNIVERSITY HOSPITAL IN (B)(6). THEREBY AN X-RAY INVESTIGATION WILL BE CARRIED OUT ON ALL METAL PARTS OF THE DEFIBRILLATION ELECTRODE SET. ONCE THIS INFORMATION BECOMES AVAILABLE WE WILL PROVIDE A FOLLOW-UP REPORT. SO FAR, NO CONCLUSION CAN BE DRAWN WHAT MIGHT HAVE CAUSED THE CLAIMED PROBLEM. THIS PRODUCT IS NOT MARKETED IN THE USA. NO 510 (K) AND NO PMA EXIST FOR IT. HOWEVER, DEVICES MADE USING A SIMILAR DESIGN ARE SOLD IN THE US. WE ARE THEREFORE REPORTING THIS INCIDENT.

Additional Manufacturer Narrative · 0

RETAINED SAMPLES OF THE CONCERNED LOT NUMBER (211108-3996) HAVE BEEN INSPECTED VISUALLY AND TESTED ELECTRICALLY FOR THE FUNCTION. ALL TESTED ELECTRODES WERE WITHIN LIMITS, NO FAILURE COULD BE DETECTED. ON (B)(6), 2022 THE INVOLVED DEVICE WAS RECEIVED IN AN OPEN POUCH. IT WAS DISINFECTED AND THEN INSPECTED. A VISUAL INSPECTION OF THE DEFIBRILLATION ELECTRODE SET SHOWED NO OBVIOUS DAMAGE. THE CONNECTOR OF THE INVOLVED ELECTRODE SET WAS ALSO VISUALLY INSPECTED. NEITHER DAMAGES NOR DEVIATIONS WERE VISIBLE. AN ELECTRICAL CONTINUITY TEST WAS PERFORMED USING A MULTIMETER TO TEST FOR ELECTRICAL CONTINUITY. THE CONTINUITY TEST WAS PERFORMED TO CHECK THE ELECTRICAL CONTINUITY BETWEEN THE CONNECTOR (PIN APEX AND STERNUM PAD) AND THE ELECTRODE (GEL AREA OF APEX AND STERNUM ELECTRODE). THE CONTINUITY TEST WAS WITHIN LIMITS. AS NO VISUAL AND NO ELECTRICAL CONTINUITY FAILURE COULD BE DETECTED AN ELECTRICAL PERFORMANCE TEST WAS CARRIED ON. THE INVOLVED ELECTRODE SETS WAS ADHERED ONTO THE DEFIBRILLATION TEST EQUIPMENT FLUKE IMPULSE 7000DP AND CONNECTED TO THE GS CORPULS DEFIBRILLATOR. THE DEFIBRILLATOR WAS SWITCHED ON AND THE PADS WORKED PROPERLY - IMMEDIATELY AN ECG SIGNAL WAS VISIBLE ON THE DISPLAY. WE HAVE SIMULATED A VENTRICULAR FIBRILLATION AND HAVE SUCCESSFULLY SHOCKED TO THE DEFIBRILLATION TEST EQUIPMENT FLUKE IMPULSE 7000DP. ON (B)(6) WE HAVE RECEIVED AN EXCERPT OF THE DATA THE DEFIBRILATOR HAD RECORDED DURING THE PROCEDURE. THE DATA PROVIDED SHOW NO CLEAR ROOT CAUSE FOR THE CLAIMED FAILURE. WE THEREFORE HAVE FURTHER INVESTIGATED THE INVOLVED DEFIBRILLATION ELECTRODE SET AT THE UNIVERSITY HOSPITAL IN INNSBRUCK. THEREBY AN X-RAY INVESTIGATION WAS CARRIED OUT ON ALL METAL PARTS OF THE DEFIBRILLATION ELECTRODE SET. AN ANOMALY CONCERNING AN EEPROM WAS DISCOVERED IN THE INVOLVED CUSTOMER SAMPLE. THE EEPROM IS CODED WITH THE SHELF LIFE INFORMATION. IN AN INTERNAL TEST THE EEPROM COULD BE READ. IT IS THEREFORE UNCLEAR WHETHER THE ANOMALY CONSTITUTES A DAMAGE. IN ANY CASE, THE EEPROM HAS NO FUNCTION WHEN USED WITH A CORPULS C3 DEFIBRILLATOR. WE CAN THEREFORE RULE OUT IT PLAYED ANY ROLE IN THE INCIDENT. NO CABLE BREAK OR SHORT CIRCUIT IN THE PLUG WAS DETECTED, WHICH WOULD HAVE BEEN A POTENTIAL ROOT CAUSE FOR THE INCIDENT. ALL COMPONENTS THAT CAN LEAD TO THE REPORTED DEFECT OR ERROR MESSAGES DO NOT SHOW ANY ABNORMALITIES. THE FUNCTION TEST OF THE INVOLVED CUSTOMER SAMPLE SHOWED NO DEVIATION. BASED ON THE INVESTIGATION RESULTS OF THE INVOLVED CUSTOMER SAMPLE AND THE PROVIDED INFORMATION ON THE PROCEDURE NO CONCLUSION CAN BE DRAWN WHAT MIGHT HAVE CAUSED THE INCIDENT. WE THEREFORE CLOSE THE INVESTIGATION. THIS PRODUCT IS NOT MARKETED IN THE USA. NO 510 (K) AND NO PMA EXIST FOR IT. HOWEVER, DEVICES MADE USING A SIMILAR DESIGN ARE SOLD IN THE US. WE ARE THEREFORE REPORTING THIS INCIDENT.

Description of Event or Problem · 0

ON (B)(6) 2022 , WE HAVE BEEN INFORMED ABOUT A MALFUNCTION WITH A DEFIBRILLATION ELECTRODE SET AT ARBEITER-SAMARITER-BUND (ASB) HANNOVER IN GERMANY. GS DEFIBRILLATION ELECTRODES CATALOGUE NUMBER 04324.3 CORPATCH EASY SCHALE (MODEL DF23T) AND A GS CORPULS DEFIBRILLATOR C3 HAD BEEN USED. THE INITIAL REPORT WAS STATING THAT "ON (B)(6) 2022 AT 5:56 P.M., THE FOLLOWING INCIDENT OCCURRED DURING A HOME RESCUE SERVICE (RESUSCITATION). A PATIENT AGED 62 COULD NOT BE DEFIBRILLATED IMMEDIATELY. THE DEFIBRILLATION ELECTRODES WERE PROFESSIONALLY GLUED ON THE PATIENT BUT DID NOT DELIVER ANY SIGNAL. AN ERROR MESSAGE WAS DISPLAYED IN THE ECG [OF THE DEFIBRILLATOR GS CORPULS C3]. THE SAME ERROR ALSO OCCURRED ON THE ECG FROM THE EMERGENCY RESCUE SERVICE [ON A SECOND DEFIBRILLATOR GS CORPULS C3]" THEREBY THE DEFIBRILLATOR FROM THE EMERGENCY RESCUE SERVICE WAS ALSO CONNECTED TO THE ELECTRODES ALREADY APPLIED AND THE ERROR WAS ALSO DISPLAYED HERE. "THE BASIC REANIMATION HAVE BEEN CONTINUED. AFTER CHANGING THE DEFIBRILLATION ELECTRODES, THE PATIENT COULD BE DEFIBRILLATED. 4-5 MINUTES DELAY IN DEFIBRILLATION. PATIENT DIED ON SITE. DEFIBRILLATION ELECTRODES AND ECG WERE SECURED" WE HAVE REQUESTED FURTHER INFORMATION ON THE INCIDENT AND THE INVOLVED SAMPLES.

Description of Event or Problem · 0

ON (B)(6), 2022, WE HAVE BEEN INFORMED ABOUT A MALFUNCTION WITH A DEFIBRILLATION ELECTRODE SET AT ARBEITER-SAMARITER-BUND (ASB) HANNOVER IN GERMANY. GS DEFIBRILLATION ELECTRODES CATALOGUE NUMBER 04324.3 CORPATCH EASY SCHALE (MODEL DF23T) AND A GS CORPULS DEFIBRILLATOR C3 HAD BEEN USED. THE INITIAL REPORT WAS STATING THAT "ON (B)(6), 2022 AT 5:56 P.M., THE FOLLOWING INCIDENT OCCURRED DURING A HOME RESCUE SERVICE (RESUSCITATION). A PATIENT AGED 62 COULD NOT BE DEFIBRILLATED IMMEDIATELY. THE DEFIBRILLATION ELECTRODES WERE PROFESSIONALLY GLUED ON THE PATIENT BUT DID NOT DELIVER ANY SIGNAL. AN ERROR MESSAGE WAS DISPLAYED IN THE ECG [OF THE DEFIBRILLATOR GS CORPULS C3]. THE SAME ERROR ALSO OCCURRED ON THE ECG FROM THE EMERGENCY RESCUE SERVICE [ON A SECOND DEFIBRILLATOR GS CORPULS C3]" THEREBY THE DEFIBRILLATOR FROM THE EMERGENCY RESCUE SERVICE WAS ALSO CONNECTED TO THE ELECTRODES ALREADY APPLIED AND THE ERROR WAS ALSO DISPLAYED HERE. "THE BASIC REANIMATION HAVE BEEN CONTINUED. AFTER CHANGING THE DEFIBRILLATION ELECTRODES, THE PATIENT COULD BE DEFIBRILLATED. 4-5 MINUTES DELAY IN DEFIBRILLATION. PATIENT DIED ON SITE. DEFIBRILLATION ELECTRODES AND ECG WERE SECURED" WE HAVE REQUESTED FURTHER INFORMATION ON THE INCIDENT AND THE INVOLVED SAMPLES. LATER ON WE HAVE BEEN INFORMED THAT NO THERAPY CABLE, I.E. AN EXTENSION CABLE BETWEEN THE DEFIBRILLATION CABLE AND THE DEFIBRILLATOR, WAS USED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1626530 GS MULTIFUNCTION DEFIBRILLATION ELECTRODE MKJ LEONHARD LANG GMBH DF23T 211108-3996 19005531505302

Patients

Seq Age Sex Outcome Treatment
1 62 YR Unknown Death