FDA Adverse Event
Malfunction
Summary report: N
AUTOPULSE RESUSCITATION SYSTEM MODEL 100
MDR report key: 2982317
·
Received January 25, 2013
Report
- Report Number
- 3003793491-2013-00232
- Event Type
- Malfunction
- Date Received
- January 25, 2013
- Date of Event
- December 31, 2012
- Report Date
- December 31, 2012
- Manufacturer
- ZOLL CIRCULATION, INC.
- Product Code
- DRM
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NV, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
ZOLL MEDICAL CORP HAS RECEIVED THE DEVICE ASSOCIATED WITH THIS REPORT; HOWEVER, THE DEVICE IS STILL UNDER INVESTIGATION. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE INVESTIGATION IS COMPLETED. NO ADVERSE EVENT REPORTED.
Description of Event or Problem · 1
IT WAS REPORTED THAT IN 3 SEPARATE EVENTS, THE PLATFORM POWERED OFF DURING ARRESTS. CUSTOMER SWAPPED THE BATTERIES AND THE PROBLEM CONTINUED. CUSTOMER ALSO INDICATED THAT THE ISSUE OCCURRED WHILE USING PLATFORM SN (B)(4). THERE IS NO INFO ABOUT OTHER 2 EVENTS, DELAY IN TREATMENT, OR THE PT OUTCOME. EVENT 1: MFR REPORT# 3003793491-2013-00230. EVENT 2: MFR REPORT# 3003793491-2013-00231. EVENT 3: MFR REPORT# 3003793491-2013-00232.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 35918 | AUTOPULSE RESUSCITATION SYSTEM MODEL 100 | CARDIAC CHEST COMPRESSOR | DRM | ZOLL CIRCULATION, INC. | MODEL 100 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |