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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 07/17/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The reported complaint that the autopulse platform (sn (b)(6) displayed the "system error, out of service, revert to manual cpr" error message was confirmed during functional testing.The root cause was the failed processor board.The autopulse platform failed initial functional testing due to the "system error, out of service, revert to manual cpr" error message displayed during take-up, thus, the reported complaint was confirmed.The processor board needs to be replaced to remedy the system error.Waiting for customer approval for repair.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
The customer reported that during shift check, the autopulse platform (sn (b)(6) displayed the "system error, out of service, revert to manual cpr" error message.The customer stores the platform on the emergency equipment rack in the emergency department (er).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 Key22822269
Report Number3010617000-2025-00549
Device Sequence Number12969751
Product Code DRM
UDI-Device Identifier00849111000017
UDI-Public00849111000017
Combination Product (Y/N)N
Initial Reporter CountryTH
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) 08/15/2025
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 Number8700-0700-01
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer07/23/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/20/2025
Initial Report FDA Received Date08/15/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/22/2024
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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