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Class 2 Device Recall Heart Sync C100Physio Radiotransparent Defibrillation Electrodes |
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Date Initiated by Firm |
April 26, 2013 |
Date Posted |
May 30, 2013 |
Recall Status1 |
Terminated 3 on April 16, 2014 |
Recall Number |
Z-1434-2013 |
Recall Event ID |
65085 |
510(K)Number |
K080421
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Product Classification |
Electrode, pacemaker, temporary - Product Code LDF
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Product |
Heart Sync C100-Physio Radiotransparent Defibrillation Electrodes Monophasic or biphasic compatible pacing/ cardioversion Defibrillation /ECG Monitoring electrodes
Used in connection with a defibrillator to deliver an electrical current (shock) to the patient's heart during cardiac emergencies. |
Code Information |
Part number : C100-Physio and Lot numbers: Y100112-02, Y102212-03, Y121312-18, Y012413-02, Y022013-01, Y032113-01 |
Recalling Firm/ Manufacturer |
Heart Sync, Inc 5643 Plymouth Rd Ann Arbor MI 48105-9586
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For Additional Information Contact |
Cathy Hagerman 734-213-5530
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Manufacturer Reason for Recall |
On 4/18/13 HEARTSYNC became aware of a recall from their wire/connector sub-assembly supplier which is used in the C100-Physio Electrodes. There were reports of equipment damage due to misalignment from tooling installed in August 2012. The result of this damage could render the device incapable of delivering the appropriate energy or shock to the patient.
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FDA Determined Cause 2 |
Process design |
Action |
HeartSync sent an URGENT MEDICAL DEVICE RECALL notification letter dated April 26, 2013, to all consignees of Heart Sync for C100-Physio Radiotransparent Defrillation Electrodes. On April 29, 2013, an URGENT MEDICAL DEVICE RECALL notification was sent to Vermed Inc for the D304 Defrillation Electrodes . The letters identified the product, the problem, and the action to be taken by the customer. Customers were instructed to return the affected product to the firm for full credit. Customers were asked to complete the form and send back via fax to 734-213-5640 or call 734-213-5530.
For questions regarding this recall call 734-213-5530.
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Quantity in Commerce |
17180 units for all part numbers |
Distribution |
Worldwide Distribution - USA including AL, GA, MI, MN, NC, ND, OH, PA, SD, VA, VT, OH, TX, MA, and Internationally to Korea. |
Total Product Life Cycle |
TPLC Device Report
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1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
3 For details about termination of a recall see Code of Federal Regulations (CFR) Title 21 §7.55.
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510(K) Database |
510(K)s with Product Code = LDF and Original Applicant = HEART SYNC LLC
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