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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZOLL MEDICAL CORPORATION AED PLUS; DEFIBRILLATOR

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ZOLL MEDICAL CORPORATION AED PLUS; DEFIBRILLATOR Back to Search Results
Model Number AED PLUS
Medical Device Problem Code Failure to Power Up (1476)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
Complainant alleged that during functional testing, the device would not power up.Complainant indicated that there was no patient involvement in the reported malfunction.
 
Additional Manufacturer Narrative
Zoll medical corporation has received the product and will be providing a supplemental report when our investigation is completed.
 
Additional Manufacturer Narrative
The device was returned to zoll medical corporation.The customer's report was not replicated or confirmed.The device was put through extensive testing including bench handling, power cycling, functional stress testing, and on/off current testing using test batteries and pads without duplicating the report.The batteries used were not returned as part of this investigation.Analysis of reports of this type has not identified an increase in trend.
 
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Brand Name
AED PLUS
Common Device Name
DEFIBRILLATOR
Manufacturer (Section D)
ZOLL MEDICAL CORPORATION
269 mill road
chelmsford MA 01824
Manufacturer Contact
269 mill road
chelmsford, MA 01824
9784219552
MDR Report Key12692462
Report Number1220908-2021-03610
Device Sequence Number4265576
Product Code MKJ
UDI-Device Identifier04560233596405
UDI-Public04560233596405
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K011541/P160
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Distributor
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 10/04/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Other
Device Model NumberAED PLUS
Device Catalogue NumberAED PLUS
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/14/2021
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/04/2021
Supplement Date Received by Manufacturer10/04/2021
Initial Report FDA Received Date10/25/2021
Supplement Report FDA Received Date11/12/2021
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/01/2020
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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