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This supplemental medwatch report is reporting the evaluation of the device and correcting information submitted on the initial medwatch report.Please reference section b1, b2, d2, h1, and h6 (health effect clinical and impact code).The returned pads were received in a compromised condition with the package opened and the gel surfaces adhered together; however, visual inspection found no evidence of arcing or burn marks.Impedance/continuity testing and a 200 j shock test were performed with passing results, and no discrepancies were identified.Review of the clinical file confirmed that on (b)(6) 2026, the device delivered a 200 j synchronized shock with an actual delivered energy of 271.10 j and a recorded patient impedance of 263 ohms.Ecg artifact was also observed.Defibrillation impedance could not be fully assessed because the requested activity log was not provided.Based on the available evidence, the reported condition may have been associated with poor pad-to-patient coupling or intermittent accessory cable connection.Factors such as inadequate skin preparation, electrode application, or patient movement may contribute to poor coupling.The evaluation did not identify a malfunction with the returned pads.Per the onestep basic's instruction for use (ifu): remove excess chest hair.Clip if necessary to maximize gel to skin contact.Clipping is recommended since shaving can leave tiny micro-abrasions that can lead to patient discomfort during pacing.Ensure skin is clean and dry under electrode.Remove any debris, ointments, skin preps, etc.With water (and mild soap if needed).Wipe off excess moisture/diaphoresis with dry cloth.Apply one edge of the electrode securely to the patient.Roll the electrode smoothly from that edge to the other.Be careful not to trap any pockets of air between the gel and skin.Excessive hair can inhibit good coupling (contact), which can lead to the possibility of arcing and skin burns.Analysis of reports of this type has not identified an increase in trend.
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