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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZOLL CIRCULATION AUTOPULSE® RESUSCITATION MODEL 100; CARDIAC CHEST COMPRESSOR

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ZOLL CIRCULATION AUTOPULSE® RESUSCITATION MODEL 100; CARDIAC CHEST COMPRESSOR Back to Search Results
Model Number MODEL 100
Device Problems Visual Prompts will not Clear (2281); Device Displays Incorrect Message (2591); Device Operational Issue (2914)
Patient Problem No Patient Involvement (2645)
Event Date 05/11/2018
Event Type  malfunction  
Manufacturer Narrative
The customer's reported complaint of autopulse platform (sn (b)(4)) displayed user advisory (ua) 02 (compression tracking error) message was confirmed during archive review but not during functional testing.There were no device deficiencies found during evaluation of the returned platform that could have caused or contributed to the reported complaint.During visual inspection, load plate cover was noted damaged and the encoder drive shaft does not rotate smoothly, exhibits binding and resistance, unrelated to the reported complaint.The autopulse platform is a reusable device and was manufactured in 2011 and has exceeded its expected service life of 5 years.Therefore, this type of physical damage found during visual inspection is characteristic of normal wear and tear for the life of the device.In addition, the pdb (power distribution board) was replaced to current revision.Following the service and repair, the autopulse was tested functionally and passed successfully with no issue or faults observed.Review of the archive data indicated user advisory (ua) 02 (compression tracking error) message was recorded around the reported event date.Advisory (ua) 02 error message alerts the operator as the drive shaft rotates and shortens/tightens the lifeband (compresses the chest), the load sensors do not see the expected increase in load.This typically occurs if the patient is misaligned on the platform or the lifeband is opened or in the incorrect position during take up/compression.The load cell characterization test confirmed both load cell modules are functioning within the specification.As part of routine service, the platform was tested with large resuscitation testing fixture, (lrtf) equivalent to 250 pound patient and failed with user advisory (ua) 17 (max motor on time exceeded during active operation), unrelated to the reported complaint.Defective drive train motor was replaced to address the issue.Historical complaints were reviewed for service information related to the reported complaint and there was no previous history of complaints reported for autopulse platform sn (b)(4).
 
Event Description
During device check, the autopulse platform (sn (b)(4)) displayed user advisory (ua) 02 (compression tracking error) message when tested on the manikin.No patient was involved.
 
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Brand Name
AUTOPULSE® RESUSCITATION MODEL 100
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
noemi schambach
2000 ringwood ave
san jose, CA 95131
4084192955
MDR Report Key7579988
MDR Text Key110459725
Report Number3010617000-2018-00622
Device Sequence Number1
Product Code DRM
UDI-Device Identifier00849111000291
UDI-Public00849111000291
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
K112998
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Reporter Occupation Service Personnel
Type of Report Initial
Report Date 06/07/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received06/07/2018
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberMODEL 100
Device Catalogue Number8700-0700-08
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/21/2018
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Date Manufacturer Received05/11/2018
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured04/28/2011
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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