FDA Adverse Event Malfunction Summary report: N

AUTOPULSE NIMH BATTERY

MDR report key: 2935288 · Received January 25, 2013

Report

Report Number
3003793491-2012-00365
Event Type
Malfunction
Date Received
January 25, 2013
Date of Event
May 1, 2012
Report Date
May 10, 2012
Manufacturer
ZOLL CIRCULATION, INC.
Product Code
DRM
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

BATTERY WAS NOT RETURNED FOR INVESTIGATION. THE CUSTOMER SCRAPPED THE FAILED BATTERY, BUT HAD TESTED IT AND PROVIDED THE DATA. BASED ON THIS DATA: FOR 3 BATTERIES (SERIAL NUMBERS UNK) PROVIDED DATA WAS CORRUPTED. CORRUPTED DATA MAY BE CAUSED BY NOT FULLY INSERTING THE BATTERY INTO THE TESTER, AND/OR A DEFECTIVE OR DAMAGED ELECTRICAL COMPONENT IN THE BATTERY. HOWEVER, THIS COULD NOT BE CONFIRMED AS THE UNITS WERE NOT RETURNED.

Description of Event or Problem · 1

IT WAS REPORTED THAT PT WAS IN CARDIAC ARREST, DURING USE, DEVICE COMPRESSED ONCE AND DISPLAYED "REPLACE BATTERY". BATTERY WAS REPLACED, SYSTEM AGAIN COMPRESSED ONCE AND DISPLAYED REPLACE BATTERY. MANUAL CPR WAS ADMINISTERED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
36117 AUTOPULSE NIMH BATTERY NIMH BATTERY DRM ZOLL CIRCULATION, INC.

Patients

Seq Age Sex Outcome Treatment
1 Death