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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 06/15/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The reported complaint that the autopulse platform (sn (b)(6)) displayed a "system error, out of service, revert to manual cpr" was confirmed during both archive data review and functional testing.The possible root cause of the system error could be related to a communication error that caused a latch-up of the processor board.Archive data review showed the occurrence of system error - 132 (internal watchdog timeout) around the customer's reported event date, confirming the reported complaint.The autopulse platform failed the preliminary functional test due to "system error, out of service, revert to manual cpr" displayed upon powering up, confirming the reported complaint.The system error was cleared using apvision3 software during the device evaluation performed at zoll service depot.Subsequently, the autopulse passed further functional tests without any fault or error.Zoll is awaiting the customer's approval for service.Historical complaints were reviewed for service information related to the reported complaint, and there were no similar complaints reported for the autopulse platform with serial number (b)(6).
 
Event or Problem Description
The customer reported that during shift check, the autopulse platform (sn (b)(6)) displayed a "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 Key22426216
Report Number3010617000-2025-00449
Device Sequence Number4631877
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) 07/07/2025
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 Manufacturer06/24/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/15/2025
Initial Report FDA Received Date07/07/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/20/2016
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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