MAUDE Adverse Event Report: HEARTSINE TECHNOLOGIES LTD 450-STR-US-10,PACKAGE,450P,PP01,EN,450-STR-US-10,BEL; AUTOMATED EXTERNAL DEFIBRILLATOR

Model Number	450P
Medical Device Problem Codes	No Audible Prompt/Feedback (2282); Unexpected Shutdown (4019)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	07/06/2023
Type of Reportable Event	Malfunction
Event or Problem Description
The customer contacted heartsine to report that their device experiences unexpected losses of power.In this state the device would be inoperable and defibrillation therapy would not be available if needed.There was no report of patient use associated to the reported event.
Additional Manufacturer Narrative
Heartsine has requested return of the device for investigation.Upon completion, the conclusions will be submitted in a follow-up report.
Event or Problem Description
The customer contacted heartsine to report that their device experiences unexpected losses of power.In this state the device would be inoperable and defibrillation therapy would not be available if needed.There was no report of patient use associated to the reported event.
Additional Manufacturer Narrative
Heartsine has made multiple attempts to contact the customer regarding the status of their device, but no response has been received from the customer.The device was not returned to heartsine for investigation.No additional information will be forthcoming at this time.The cause of the reported issue could not be determined.If the device is returned to the manufacturer the investigation will be reopened.H3 other text : device not returned for evaluation.
Event or Problem Description
The customer contacted heartsine to report that their device experiences unexpected losses of power.In this state the device would be inoperable and defibrillation therapy would not be available if needed.There was no report of patient use associated to the reported event.
Additional Manufacturer Narrative
Heartsine's investigation of the device confirmed the reported fault as upon return the device did not issue voice prompts.The reported fault was attributed to a damaged speaker cable.The device was scrapped by heartsine and the customer was provided with a replacement device.

• Brand Name: 450-STR-US-10,PACKAGE,450P,PP01,EN,450-STR-US-10,BEL
• Common Device Name: AUTOMATED EXTERNAL DEFIBRILLATOR
• Manufacturer (Section D): HEARTSINE TECHNOLOGIES LTD; 207 airport road west; belfast BT3 9 ED; EI BT3 9ED
• Manufacturer (Section G): HEARTSINE TECHNOLOGIES LTD; 207 airport road west; belfast BT3 9 ED; EI BT3 9ED
• Manufacturer Contact: dara friedman ; 207 airport road west; belfast BT3 9-ED ; EI BT3 9ED ; 4258674577
• MDR Report Key: 17435632
• Report Number: 3004123209-2023-00104
• Device Sequence Number: 6835151
• Product Code: MKJ
• UDI-Device Identifier: 05060167120695
• UDI-Public: 05060167120695
• Combination Product (Y/N): N
• Initial Reporter State: FL
• Initial Reporter Country: US
• PMA/510(K) Number: P160008
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Consumer
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 11/30/2023

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: Lay User/Patient
• Device Model Number: 450P
• Device Catalogue Number: 450-STR-US-10
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Type of Report(Section G): Follow-Up
• Initial Date Received by Manufacturer: 07/06/2023
• Supplement Date Received by Manufacturer: 08/22/2023; 11/06/2023
• Initial Report FDA Received Date: 08/01/2023
• Supplement Report FDA Received Date: 09/19/2023; 11/30/2023
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 08/18/2019
• 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 Number: 1
• Patient Sex: Unknown