BEUDAMED
    FDA Adverse Event Death Summary report: N

    ZOLL M SERIES

    MDR report key: 2565654 · Received March 29, 2012

    Report

    Report Number
    2565654
    Event Type
    Death
    Date Received
    March 29, 2012
    Date of Event
    March 23, 2012
    Report Date
    March 29, 2012
    Manufacturer
    ZOLL
    Product Code
    MKJ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    DEFIBRILLATOR DID NOT DELIVER SHOCK DURING CODE. FIRST DEFIBRILLATOR ATTEMPTED WITH PADS AND DID NOT DELIVER SHOCK. ERROR MESSAGE "POOR PAD SHORT." SECOND DEFIBRILLATOR ATTEMPTED BOTH PADS AND PADDLES AND DID NOT DELIVER SHOCK. UNK IF ERROR MESSAGE DISPLAYED ON SECOND UNIT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZOLL M SERIES DEFIBRILLATOR MKJ ZOLL 0197

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Death