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U.S. Department of Health and Human Services

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

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ZOLL MEDICAL CORPORATION R SERIES; DEFIBRILLATOR/PACEMAKER Back to Search Results
Model Number 30001004101110012
Medical Device Problem Code Defibrillation/Stimulation Problem (1573)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was returned to zoll medical corporation.During the investigation it was noted that the reported incident defib fault 76 and defib disabled on power up was observed and verified to a defective pace/defib (pd) engine and it was replaced to resolve the issue.The pd engine was scrapped.The device recertified.No emerging trend based on similar reports.
 
Event or Problem Description
Complainant alleged that during biomed testing, the device displayed a "defib fault 76" message.Complainant indicated that there was no patient involvement in the reported malfunction.
 
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Brand Name
R 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 Key24524290
Report Number1220908-2026-00627
Device Sequence Number15889294
Product Code MKJ
UDI-Device Identifier00847946017439
UDI-Public(01)00847946017439
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
P160022
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 02/12/2026
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 Number30001004101110012
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/19/2026
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/12/2026
Initial Report FDA Received Date03/05/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/01/2024
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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