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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZOLL MEDICAL CORPORATION X SERIES; DEFIBRILLATOR/PACEMAKER

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ZOLL MEDICAL CORPORATION X SERIES; DEFIBRILLATOR/PACEMAKER Back to Search Results
Model Number 620-2271511-01
Medical Device Problem Code Unable to Obtain Readings (1516)
Health Effect - Clinical Code Insufficient Information (4580)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Zoll medical corporation has received the product and will be providing a supplemental report when our investigation is completed.
 
Event or Problem Description
Complainant alleged that while attempting to treat a patient (age & gender unknown), the device displayed an "ecg monitoring failure" message.Complainant did not indicate that there was any adverse effect to the patient due to the reported malfunction.
 
Additional Manufacturer Narrative
The device was returned to zoll medical corporation for evaluation.The device was evaluated and we were unable to duplicate the customer's report.Bench handling and stress testing of the device were performed without success of duplicating a malfunction.Review of the device logs during the time of the event showed signs of intermittent connection to the multifucntion cable (mfc).The mfc was not returned to zoll as part of the investigation.The device was recertified and returned to the customer.No trend is associated with reports of this type.
 
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Brand Name
X SERIES
Common Device Name
DEFIBRILLATOR/PACEMAKER
Manufacturer (Section D)
ZOLL MEDICAL CORPORATION
269 mill road
chelmsford MA 01824
Manufacturer Contact
scott august
269 mill road
chelmsford, MA 01824
9784219552
MDR Report Key22808393
Report Number1220908-2025-02885
Device Sequence Number15665176
Product Code MKJ
UDI-Device Identifier00847946019778
UDI-Public(01)00847946019778
Combination Product (Y/N)N
Initial Reporter StateMS
Initial Reporter CountryUS
PMA/510(K) Number
P160022
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 07/25/2025
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 Number620-2271511-01
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer07/31/2025
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 07/25/2025
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date08/14/2025
Supplement Report FDA Received Date09/03/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/01/2020
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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