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 |