Class 2 Device Recall AM12M

• Date Initiated by Firm: March 31, 2021
• Create Date: April 22, 2021
• Recall Status: Completed
• Recall Number: Z-1485-2021
• Recall Event ID: 87686
• Product Classification: Electrocardiograph - Product Code DPS
• Product: AM12M Acquisition Module accessory. Impacted software version of the AM12M is version 1.5.1 - Product Usage: indicated for use on adult and pediatric populations.
• Code Information: Part Number: 41000-037-50 (Device Identifier: 812345029666); S/N: 119030001449, 119030001451, 119030001447, 119030001450, 119190000644, 117200568671, 116520545406, 118030607566, 117510602011, 117060553537, 118030607568, 118030607569, 118030607570, 117270577273, 117200568670, 117060553536, 117120556677, 117220571046, 116530547186, 118180635011, 116510544918 Part Number: 41000-037-51 (Device Identifier: 812345029673); S/N: 118330001224, 118330001229, 118330001226, 118330001222, 118330001221, 118330001223, 118330001225, 118330001228, 118330001230, 118330001227, 118370000736, 118350001181, 118410000928, 118410000929, 119140000221, 119140000222, 119140000223, 119420001690, 120070000301, 120070000300, 120070000297, 120070000302, 120070000295, 120070000299, 120070000296, 120070000298, 118070612689, 116440535497, 116440535498, 116440535499, 116440535500, 116530547301, 116530547302, 116530547303, 116530547304, 117040552121, 117040552122, 117040552123, 117040552124, 118130624261, 118130624262 Part Number: 9293-065-50 (Device Identifier: 812345029710); S/N: 118260000305, 118260000306, 118260000307, 118260000308, 118260000309, 118260000310, 118260000311, 118260000855, 118260000856, 118260000857, 118260000858, 118260000859, 118260000860, 118260000861, 118260000862, 118290001080, 118290001081, 118290001082, 118290001083, 118290001084, 118290001085, 118290001088, 118290001090, 118290001091, 118290001093, 118290001094, 118290001097, 118330000945, 118330000946, 118330000950, 118330000952, 118340001214, 118340001215, 118340001221, 118380002053, 118380002063, 118410000049, 118410000050, 118410000053, 118410000055, 118410000056, 118410000057, 118410000058, 118410000059, 118410000060, 118410000061, 118410000063, 118410000065, 118410000066, 118410000067, 118410000113, 118410000114, 118450000570, 118450000571, 118450000572, 118450000573, 118450000574, 118450000575, 118450000576, 118450000577, 118450000578, 118450000579, 118450000580, 118450000581, 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119120001273, 119120001274, 119120001275, 119120001276, 119120001277, 119120001278, 119120001279, 119120001280, 119120001281, 119120001282, 119160000351, 119160000352, 119160000353, 119160000354, 119160000355, 119160000356, 119160000357, 119160000358, 119160000359, 119160000360, 119180000721, 119180000722, 119180000723, 119180000724, 119180000725, 119180000726, 119180000727, 119180000728, 119180000729, 119180000730, 119180000731, 119180000732, 119180000733, 119180000734, 119180000735, 119180000737, 119180000738, 119180000743, 119180000744, 119190000996, 119190000997, 119190000998, 119190000999, 119190001000, 119190001001,,, 119190001002, 119190001003, 119190001004, 119190001005, 119190001381, 119190001382, 119190001383, 119190001384, 119190001385, 119190001386, 119190001387, 119190001388, 119190001389, 119190001390, 119190001391, 119190001392, 119190001393, 119190001394, 119190001395, 119230000110, 119230000111, 119230000112, 119230000113, 119230000114, 119230000115, 119230000116, 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120060000635, 120060000636, 120110001720, 120110001721, 120110001722, 120110001723, 120110001724, 120140000961, 120140000964, 120140002418, 120140002421, 120140002422, 120140002423, 120140002425, 120140002426, 120140002428, 120140002429, 120140002430, 120140002433, 120140002437, 120140002438, 120140002444, 120140002447, 120140002448, 120140002451, 120140002452, 120140002453, 117160563851, 117500600575, 116390529419, 116490542198, 118180634091, 116470539365, 116470539366, 118040608361, 117030550967, 117030550968, 117500600568, 117260576877, 117260576884, 116430533868, 117280577903, 118060610984, 117160563854, 117140561705, 118060610981, 118060610967, 118060610995, 117230572782, 117160563852, 116410531264, 117080555200, 117220571047, 116530547331, 118180634101, 117390588733, 116430533876, 116430533877, 116430533878, 116430533879, 117080555192, 117230572787, 117460595351, 117230572785, 118040608360, 116240475613, 116240475614, 116240475615, 116310521404, 116310521405, 116310521406, 116310521407, 116310521408, 116310521409, 116360525383, 116360525384, 116360525385, 116390529418, 116390529421, 116390529422, 116390529425, 116390529426, 116390529428, 116390529429, 116490542214, 116490542215, 116520545886, 116520545887, 117080555197, 117080555198, 117230572774, 117080555199, 117080555201, 117140561696, 117140561697, 117140561698, 117140561699, 117140561700, 117140561701, 117220571057, 117220571060, 117230572772, 117230572775, 117230572784, 117230572786, 117230572788, 117230572789, 117230572790, 117230572791, 117260576872, 117260576874, 117260576875, 117260576876, 117260576879, 117260576880, 117260576881, 117260576882, 117260576883, 117280577911, 117280577919, 117460595346, 117460595364, 117500600565, 117500600567, 117500600569, 117500600573, 117500600574, 117500600576, 117500600577, 117500600579, 116240475616, 116240475617, 116240475618, 116240475619, 116240475620, 116240475621, 116240475622, 116240475623, 116240475624, 116240475625, 116240475626, 116260496380, 116330522663, 116330522870, 116360525806, 116360525807, 116360525808, 116360525809, 116360525810, 116390529417, 116390529420, 116390529423, 116390529424, 116390529427, 116430533873, 116470539362, 116470539363, 116470539364, 116470539367, 116490542196, 116490542197, 116490542199, 116490542200, 116490542201, 116490542202, 116490542203, 116490542204, 116490542205, 116490542206, 116490542207, 116490542209, 116490542210, 116490542211, 116490542212, 116490542213, 116520545931, 117010548836, 117010548837, 117010548838, 117010548839, 117500600570, 117010548840, 117010548841, 117010548842, 117010548843, 117010548844, 117030550969, 117030550970, 117030550971, 117030550972, 117030550973, 117030550974, 117030550975, 117030550976, 117080555196, 117080555202, 117080555204, 117080555207, 117080555211, 117160563853, 117220571048, 117220571051, 117220571056, 117220571061, 117260576878, 117280577904, 117280577905, 117280577906, 117280577907, 117280577908, 117280577909, 117280577912, 117280577913, 117280577916, 117280577921, 117390588716, 117390588718, 117390588719, 117390588720, 117390588721, 117390588722, 117390588723, 117390588727, 117390588730, 117390588732, 117450593715, 117450593716, 117450593719, 117450593722, 117450593723, 117450593724, 117460595345, 117460595347, 117460595349, 117460595350, 117460595352, 117460595354, 117460595355, 117460595357, 117460595358, 117460595359, 117460595362, 117460595363, 117460595365, 117460595366, 117460595367, 117460595368, 117460595369, 116520545888, 116210444884, 116210444885, 116210444886, 116210444887, 116210444888, 116210444889, 116210444890, 116210444891, 116210444892, 116210444893, 116210444894, 116210444895, 116210444897, 116210444898, 116210444899, 116210444901, 116210444903, 116210444908, 116210444909, 116490542216, 116490542217, 116490542218, 116490542219, 116490542220, 116490542221, 116490542222, 116490542223, 116490542224, 116490542225, 116490542226, 116490542227, 116490542228, 116490542229, 116490542230, 116490542231, 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• Recalling Firm/ Manufacturer: Welch Allyn Inc Mortara ; 7865 N 86th St; Milwaukee WI 53224-3431
• For Additional Information Contact: Welch Allyn Technical Support; 888-667-8272
• Manufacturer Reason for Recall: Devices do not meet IEC 60601-2-27 requirements as labeled.
• FDA Determined Cause: Process control
• Action: Recall notification letters were mailed to customers notifying them of the potential issue with recommended actions beginning April 7, 2021. The notification letter includes an acknowledgement form that must be returned to the recalling firm. Once the customer confirms the impacted units are in possession, the recalling firm will arrange for an exchange AM12M to be provided. The recalled unit will be returned to the recalling firm's service center for processing.
• Quantity in Commerce: 746 units
• Distribution: US Nationwide distribution in the states of CA, CO, FL, GA, IN, LA, NC, NJ, NV, NY, OH, OK, TX, UT, and VA.
• Total Product Life Cycle: TPLC Device Report

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.