FDA Adverse Event
Malfunction
Summary report: N
AUTOPLUSE RESUSCITATION SYSTEM MODEL 100
MDR report key: 2953875
·
Received January 11, 2013
Report
- Report Number
- 3003793491-2013-00093
- Event Type
- Malfunction
- Date Received
- January 11, 2013
- Date of Event
- October 10, 2012
- Report Date
- December 13, 2012
- Manufacturer
- ZOLL CIRCULATION, INC.
- Product Code
- DRM
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SN
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
ZOLL MEDICAL CORP HAS NOT YET RECEIVED THE DEVICE. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE DEVICE IS RECEIVED AND EVALUATED. NO ADVERSE EVENT REPORTED.
Description of Event or Problem · 1
IT WAS REPORTED THAT DURING DEPLOYMENT, THE LIFEBAND GOT LOOSE AND THE CUSTOMER WAS NOT ABLE TO USE THE PLATFORM. MANUAL CPR WAS PERFORMED BEFORE THE LIFEBAND WAS RE-ADJUSTED FOR USE. NO ADVERSE EVENT REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 17510 | AUTOPLUSE RESUSCITATION SYSTEM MODEL 100 | CARDIAC CHEST COMPRESSOR | DRM | ZOLL CIRCULATION, INC. | 100 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |