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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZOLL CIRCULATION AUTOPULSE® PLATFORM RESUSCITATION; CARDIAC CHEST COMPRESSOR

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ZOLL CIRCULATION AUTOPULSE® PLATFORM RESUSCITATION; CARDIAC CHEST COMPRESSOR Back to Search Results
Model Number MODEL 100
Device Problem Failure to Power Up (1476)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 11/15/2021
Event Type  malfunction  
Manufacturer Narrative
The reported complaint that the autopulse platform (serial #(b)(4)) will not power on was confirmed during functional testing and visual inspection.The root cause of the reported complaint was due to a broken battery compartment along with a kinked battery cable wires and a missing battery lock, likely not allowing good contact when a autopulse li-ion battery was inserted.The physical damage appeared to be the characteristics of harsh impact due to user mishandling.Further visual inspection of the returned autopulse platform revealed a cracked top cover, front and bottom enclosures, and a burnt/damaged lcd screen, unrelated to the reported complaint.The observed physical damages appeared to be the characteristics of harsh impact due to user mishandling.All the damaged parts and covers were replaced to address the issues.During archive data review, record shows last power up of the device was on 04/20/2020.During functional testing, the autopulse platform failed to power up, thus confirming the reported complaint.The root cause of the reported complaint was due to a broken battery compartment along with a kinked battery cable wires and a missing battery lock, likely not allowing good contact when a autopulse li-ion battery was inserted.The physical damage appeared to be the characteristics of harsh impact due to user mishandling.The battery compartment, battery cable wires and battery lock needs to be replaced to remedy the reported power issue.Zoll is awaiting customer's approval for service repair.Historical complaints were reviewed for service information related to the reported complaint, and there was no similar complaint reported for autopulse platform with serial number (b)(4).
 
Event Description
During shift check, the autopulse platform (serial #(b)(4)) will not power on due to the battery compartment is broken and the battery is not making any good contact.No patient involvement.
 
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Brand Name
AUTOPULSE® PLATFORM RESUSCITATION
Type of Device
CARDIAC CHEST COMPRESSOR
Manufacturer (Section D)
ZOLL CIRCULATION
2000 ringwood ave.
san jose CA 95131
Manufacturer (Section G)
ZOLL CIRCULATION
2000 ringwood ave.
san jose CA 95131
Manufacturer Contact
kim thoa nguyen
2000 ringwood ave,
san jose, CA 95131
4084192922
MDR Report Key12969697
MDR Text Key283478516
Report Number3010617000-2021-01138
Device Sequence Number1
Product Code DRM
UDI-Device Identifier00849111000017
UDI-Public00849111000017
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K112998
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,User Facility,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 12/09/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/09/2021
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberMODEL 100
Device Catalogue Number8700-0700-01
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/24/2021
Is the Reporter a Health Professional? Yes
Date Manufacturer Received11/15/2021
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured11/02/2007
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
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