FDA Adverse Event Death Summary report: N

AVIVE AED WITH AVIVE CONNECT

MDR report key: 19323410 · Received May 15, 2024

Report

Report Number
3026007685-2024-00002
Event Type
Death
Date Received
May 15, 2024
Date of Event
April 15, 2024
Report Date
May 14, 2024
Manufacturer
AVIVE SOLUTIONS, INC.
Product Code
MKJ
UDI-DI
00860002508559
PMA / PMN Number
P210015
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE CUSTOMER CONTACTED AVIVE TO REPORT THAT WHILE USING THE DEVICE ON A PATIENT, THE DEVICE WAS UNABLE TO DETECT THE PATIENT AFTER ELECTRODE PADS WERE PLACED ON THE PATIENT. THE DEVICE AND ELECTRODE PADS WERE RETURNED TO AVIVE FOR INVESTIGATION. THE DEVICE WAS PUT THROUGH THOROUGH TESTING. THE DEVICE WAS ABLE TO SUCCESSFULLY DETECT A PHYSIOLOGICAL PATIENT SIMULATOR AT THE NOMINAL, LOWER AND UPPER BOUND IMPEDANCES AND DELIVER MULTIPLE DEFIBRILLATION SHOCKS WITHIN SPEC. ADDITIONALLY, AN INTERNAL INSPECTION OF THE DEVICE ELECTRONICS SHOWED NO EVIDENCE OF ISSUES OR FAILED COMPONENTS, FURTHER CORROBORATING THE ABILITY TO SUCCESSFULLY DETECT IMPEDANCE ACROSS THE FULL RANGE. THE ELECTRODE PADS WERE INVESTIGATED AND SHOWED NO EVIDENCE OF POOR ELECTRICAL CONNECTION, MECHANICAL DISCONNECTION, OR MATERIAL FAILURES. INVESTIGATION OF THE DEVICE LOGS REVEALED THAT THE PATIENT IMPEDANCE WAS OUTSIDE OF THE ACCEPTABLE IMPEDANCE RANGE FOR THE ENTIRETY OF THE EVENT. THIS INDICATES THAT THE PADS WERE NOT MAKING PROPER CONNECTION TO THE PATIENT, WHICH CAN OCCUR FOR MULTIPLE REASONS. THE DEVICE WAS SCRAPPED AND THE CUSTOMER WAS SHIPPED A REPLACEMENT DEVICE.

Additional Manufacturer Narrative · 0

THE CUSTOMER CONTACTED AVIVE TO REPORT THAT WHILE USING THE DEVICE ON A PATIENT, THE DEVICE WAS UNABLE TO DETECT THE PATIENT AFTER ELECTRODE PADS WERE PLACED ON THE PATIENT. THE DEVICE AND ELECTRODE PADS WERE RETURNED TO AVIVE FOR INVESTIGATION. THE DEVICE WAS PUT THROUGH THOROUGH TESTING. THE DEVICE WAS ABLE TO SUCCESSFULLY DETECT A PHYSIOLOGICAL PATIENT SIMULATOR AT THE NOMINAL, LOWER AND UPPER BOUND IMPEDANCES AND DELIVER MULTIPLE DEFIBRILLATION SHOCKS WITHIN SPEC. ADDITIONALLY, AN INTERNAL INSPECTION OF THE DEVICE ELECTRONICS SHOWED NO EVIDENCE OF ISSUES OR FAILED COMPONENTS, FURTHER CORROBORATING THE ABILITY TO SUCCESSFULLY DETECT IMPEDANCE ACROSS THE FULL RANGE. THE ELECTRODE PADS WERE INVESTIGATED AND SHOWED NO EVIDENCE OF POOR ELECTRICAL CONNECTION, MECHANICAL DISCONNECTION, OR MATERIAL FAILURES. INVESTIGATION OF THE DEVICE LOGS REVEALED THAT THE PATIENT IMPEDANCE WAS OUTSIDE OF THE ACCEPTABLE IMPEDANCE RANGE FOR THE ENTIRETY OF THE EVENT. THIS INDICATES THAT THE PADS WERE NOT MAKING PROPER CONNECTION TO THE PATIENT, WHICH CAN OCCUR FOR MULTIPLE REASONS. THE DEVICE WAS SCRAPPED AND THE CUSTOMER WAS SHIPPED A REPLACEMENT DEVICE.

Description of Event or Problem · 0

THE CUSTOMER CONTACTED AVIVE TO REPORT WHILE USING THE DEVICE ON A PATIENT, THE DEVICE WAS UNABLE TO DETECT THE PATIENT AFTER ELECTRODE PADS WERE PLACED ON THE PATIENT. THE CUSTOMER PROVIDED THE FOLLOWING DETAILS DURING A FOLLOW UP WITH THE CUSTOMER: THE PATIENT WAS HIT BY A CAR AND WAS UNRESPONSIVE AT THE SCENE. ONCE POLICE ARRIVED, THE DEVICE WAS PLACED ON THE PATIENT.

Description of Event or Problem · 0

THE CUSTOMER CONTACTED AVIVE TO REPORT WHILE USING THE DEVICE ON A PATIENT, THE DEVICE WAS UNABLE TO DETECT THE PATIENT AFTER ELECTRODE PADS WERE PLACED ON THE PATIENT. THE CUSTOMER PROVIDED THE FOLLOWNG DETAILS DURING A FOLLOW UP WITH THE CUSTOMER: THE PATIENT WAS HIT BY A CAR AND WAS UNRESPONSIVE AT THE SCENE. ONCE POLICE ARRIVED, THE DEVICE WAS PLACED ON THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1547200 AVIVE AED WITH AVIVE CONNECT AUTOMATED EXTERNAL DEFIBRILLATOR MKJ AVIVE SOLUTIONS, INC. 00860002508559

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Death