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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 30001007201310013
Medical Device Problem Code Unable to Obtain Readings (1516)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/17/2026
Type of Reportable Event Malfunction
Event or Problem Description
Complainant alleged that while attempting to treat a patient (age & gender unknown), the device was unable to obtain an ecg signal via electrode pads.Complainant indicated that there was no adverse effect to the patient due to the reported malfunction.
 
Additional Manufacturer Narrative
The device was returned to zoll medical corporation.During the investigation it was noted that the reported problem that the no ecg signal from three leads or pads during follow-up testing was verified.During the evaluation, it was found that the 11 pin cable was not seated fully onto the connector of the pd engine as the cause of the problem.The 11 pin cable was reseated to remedy the problem.The device was recertified and returned to the customer.No emerging trend based on similar reports.
 
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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 Key24778506
Report Number1220908-2026-01147
Device Sequence Number13233818
Product Code MKJ
UDI-Device Identifier00847946017620
UDI-Public(01)00847946017620
Combination Product (Y/N)N
Initial Reporter StateNY
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) 03/18/2026
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 Health Professional
Device Model Number30001007201310013
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/24/2026
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/18/2026
Initial Report FDA Received Date04/03/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/01/2019
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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