FDA Adverse Event Malfunction Summary report: N

R SERIES

MDR report key: 22335596 · Received June 26, 2025

Report

Report Number
1220908-2025-02212
Event Type
Malfunction
Date Received
June 26, 2025
Report Date
June 6, 2025
Manufacturer
ZOLL MEDICAL CORPORATION
Product Code
MKJ
PMA / PMN Number
P160022
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

JUSTIFICATION FOR NO UDI, THIS DEVICE WAS MANUFACTURED BUT NOT DOMESTICALLY DISTRIBUTED; IT IS ONLY DISTRIBUTED IN THE INTENDED GEOGRAPHY. THERE IS NO EXISTING UDI REGULATION. ZOLL MEDICAL CORPORATION HAS NOT RECEIVED THE DEVICE FOR EVALUATION AND THIS COMPLAINT IS STILL UNDER INVESTIGATION.

Additional Manufacturer Narrative · 0

ZOLL MEDICAL CANADA EVALUATED THE DEVICE AND THE CUSTOMER'S REPORT WAS NOT REPLICATED OR CONFIRMED. THE DEVICE WAS PUT THROUGH EXTENSIVE TESTING, WHICH INCLUDED FUNCTIONAL TESTING WITHOUT DUPLICATING THE CUSTOMER'S REPORT. THE PRIMARY ECG SHIELD, PRIMARY MFE SHIELD, SECONDARY ECG SHIELD, AND SECONDARY MFE SHIELD WERE REPLACED AS A PRECAUTION. THE DEVICE WAS RECERTIFIED AND RETURNED TO THE CUSTOMER. NO TREND IS ASSOCIATED WITH REPORTS OF THIS TYPE.

Description of Event or Problem · 0

COMPLAINANT ALLEGED THAT DURING BIOMED TESTING, THE DEVICE FAILED LEAKAGE CURRENT TEST. COMPLAINANT INDICATED THAT THERE WAS NO PATIENT INVOLVEMENT IN THE REPORTED MALFUNCTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1491004 R SERIES DEFIBRILLATOR/PACEMAKER MKJ ZOLL MEDICAL CORPORATION 30001005201310062 NA

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown