FDA Adverse Event
Malfunction
Summary report: N
AUTOPULSE RESUSCITATION SYSTEM MODEL 100
MDR report key: 2920210
·
Received December 17, 2012
Report
- Report Number
- 3003793491-2012-00513
- Event Type
- Malfunction
- Date Received
- December 17, 2012
- Date of Event
- November 8, 2012
- Report Date
- November 8, 2012
- Manufacturer
- ZOLL CIRCULATION, INC.
- Product Code
- DRM
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
REPORTED COMPLAINT OF "USER ADVISORY 45" (NOT AT "HOME" POSITION AFTER POWER-ON/RESTART) WAS CONFIRMED. DRIVE SHAFT WAS ROTATED BACK TO HOME POSITION; THIS RESOLVED THE COMPLAINT. FURTHERMORE, TOP COVER AND FRONT ENCLOSURE WERE CRACKED AND BATTERY LOCK WAS MISSING. DAMAGED/MISSING PARTS WERE REPLACED; PLATFORM PASSED FINAL TEST. NO ADVERSE EVENT REPORTED.
Description of Event or Problem · 1
CUSTOMER REPORTED : "UA45" (USER ADVISORY 45). NO ADVERSE EVENT REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | AUTOPULSE RESUSCITATION SYSTEM MODEL 100 | CARDIAC CHEST COMPRESSOR | DRM | ZOLL CIRCULATION, INC. | 100 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |