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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZOLL CIRCULATION, INC AUTOPULSE®RESUSCITATION SYSTEM; CARDIAC RESUSCITATOR, LINE-POWERED

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ZOLL CIRCULATION, INC AUTOPULSE®RESUSCITATION SYSTEM; CARDIAC RESUSCITATOR, LINE-POWERED Back to Search Results
Model Number 100
Medical Device Problem Code Visual Prompts will not Clear (2281)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
During service, the autopulse platform (sn (b)(6)) displayed a user advisory (ua) 07 (discrepancy between load 1 and load 2 too large) message during functional testing.The root cause of the ua07 was the failure of both single point load cells.The autopulse platform failed the initial functional testing due to the displayed ua07 error message upon powering on.Both load cells were replaced to remedy the reported complaint.Following service, the platform passed the load cell characterization check and the run-in test without any fault or error.The autopulse platform passed the final testing without any fault or error.Historical complaints were reviewed for service information related to the reported complaint, and there was no previous history of complaints reported for autopulse platform with serial number (b)(6).
 
Event or Problem Description
During service, the loaner autopulse platform (sn (b)(6)) displayed a user advisory (ua) 07 (discrepancy between load 1 and load 2 too large) message.No patient involvement.
 
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Brand Name
AUTOPULSE®RESUSCITATION SYSTEM
Common Device Name
CARDIAC RESUSCITATOR, LINE-POWERED
Manufacturer (Section D)
ZOLL CIRCULATION, INC
2000 ringwood ave
san jose CA 95131
Manufacturer (Section G)
ZOLL CIRCULATION, INC
2000 ringwood ave
san jose CA 95131
Manufacturer Contact
kimthoa sackrison
2000 ringwood ave
san jose, CA 95131
MDR Report Key21883531
Report Number3010617000-2025-00287
Device Sequence Number7899949
Product Code DRM
UDI-Device Identifier00849111000772
UDI-Public00849111000772
Combination Product (Y/N)N
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
K112998
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Other
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 04/22/2025
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 Number100
Device Catalogue Number8700-0730-01-66
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/28/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/28/2025
Initial Report FDA Received Date04/22/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/14/2021
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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