BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AUTOPULSE RESUSCITATION SYSTEM MODEL 100

    MDR report key: 2971906 · Received January 18, 2013

    Report

    Report Number
    3003793491-2013-00114
    Event Type
    Malfunction
    Date Received
    January 18, 2013
    Date of Event
    December 19, 2012
    Report Date
    December 20, 2012
    Manufacturer
    ZOLL CIRCULATION, INC.
    Product Code
    DRM
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    ZOLL MEDICAL CORPORATION HAS NOT YET RECEIVED THE DEVICE. A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF THE DEVICE IS RECEIVED AND WHEN IT IS EVALUATED. NO ADVERSE EVENT REPORTED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PLATFORM STOPPED AFTER 10 SECONDS AND REQUIRED THAT THE BATTERY BE CHANGED. A FRESH BATTERY WAS PLACED IN THE PLATFORM WITH THE SAME RESULT. THREE BATTERIES WERE USED, ALL WERE READING FLAT. NO ADVERSE EVENT REPORTED. THIS REPORT PERTAINS TO THE AUTOPULSE PLATFORM. THREE BATTERIES ARE DISCUSSED IN MFR REPORT#: 3003793491-2013-00115, 3003793491-2013-00116, 3003793491-2013-00117.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    28755 AUTOPULSE RESUSCITATION SYSTEM MODEL 100 CARDIAC CHEST COMPRESSOR DRM ZOLL CIRCULATION, INC. 100

    Patients

    Seq Age Sex Outcome Treatment
    1 Other