FDA Adverse Event Malfunction Summary report: N

M SERIES

MDR report key: 3112103 · Received May 2, 2013

Report

Report Number
1220908-2013-01054
Event Type
Malfunction
Date Received
May 2, 2013
Report Date
April 15, 2013
Manufacturer
ZOLL MEDICAL CORPORATION
Product Code
MKJ
PMA / PMN Number
K990762
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
EG
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ZOLL MEDICAL CORPORATION HAS NOT RECEIVED THE DEVICE FOR EVAL AND THIS COMPLAINT IS STILL UNDER INVESTIGATION.

Description of Event or Problem · 1

COMPLAINANT ALLEGED THAT DURING A ROUTINE SHIFT CHECK BY A CLINICIAN, THE DEVICE DISPLAYED A "DEFIB FAULT 72" MESSAGE. COMPLAINANT INDICATED THAT THERE WAS NO PT INVOLVEMENT IN THE REPORTED MALFUNCTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
191275 M SERIES DEFIBRILLATOR/PACEMAKER MKJ ZOLL MEDICAL CORPORATION M SERIES BI-PHASIC NA

Patients

Seq Age Sex Outcome Treatment
1 NA