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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)
Date of Event 06/04/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The reported complaint that the autopulse platform (sn (b)(6)) displayed "system error, out of service, revert to manual cpr" was confirmed in the archive data and during functional testing.The root cause of the system error was the drivetrain motor brake gap being too wide and out of specification, likely attributed to the device's aging.The device's life expectancy is 5 years.The autopulse platform was manufactured in december 2011 and is over 13 years old.Reviewing the archive data showed a system error, 139 (unable to hold compression position) on the customer's reported event date, confirming the reported complaint.The autopulse platform failed initial functional testing due to "system error, out of service, revert to manual cpr" upon powering up, confirming the reported complaint.Investigation revealed that the drivetrain motor brake gap was too wide and out of specification, which triggered the system error.Since the brake gap could not be adjusted to meet specifications, the drivetrain motor assembly must be replaced to remedy the problem.Zoll is awaiting the customer's approval for repair.Historical complaints were reviewed for service information related to the reported complaint, and no similar complaints were reported for the autopulse platform with serial number (b)(6).
 
Event or Problem Description
During shift check, the autopulse platform (sn (b)(6)) displayed "system error, out of service, revert to manual cpr." 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
kim thoa sackrison
2000 ringwood ave.
san jose, CA 95131
4084192347
MDR Report Key22324445
Report Number3010617000-2025-00469
Device Sequence Number8794136
Product Code DRM
UDI-Device Identifier00849111065009
UDI-Public00849111065009
Combination Product (Y/N)N
Initial Reporter CountryJA
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 Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 06/24/2025
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 Health Professional
Device Model Number100
Device Catalogue Number8700-0700-03
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/14/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/04/2025
Initial Report FDA Received Date06/24/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/20/2011
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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