MAUDE Adverse Event Report: ZOLL CIRCULATION AUTOPULSE® PLATFORM RESUSCITATION; CARDIAC CHEST COMPRESSOR

Model Number	MODEL 100
Medical Device Problem Code	Visual Prompts will not Clear (2281)
Health Effect - Clinical Code	No Patient Involvement (2645)
Date of Event	01/09/2020
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
During preventive maintenance on january 9, 2020 and during functional testing, the autopulse platform (serial #(b)(4)) displayed "stopping" error message.The probable cause of the error message issue was likely due to a damaged drive train in which is likely attributed to normal wear and tear.The autopulse platform was manufactured in august 2015 and it is nearing its expected serviceable life of 5 years.The drive train was replaced to remedy the error message.No physical damage was observed on the autopulse platform during visual inspection.After service completion, the autopulse was subjected to the run-in test using the 95% patient large resuscitation test fixture (lrtf) with good known test battery until discharged without any fault or error.The autopulse platform passed all functional tests.Historical complaints were reviewed for service information related to the reported complaint and there were no previous history of complaints reported for autopulse with serial number (b)(4).
Event or Problem Description
During preventive maintenance on january 9, 2020, the returned autopulse platform (serial #(b)(4)) displayed "stopping" error message during functional test.

• Brand Name: AUTOPULSE® PLATFORM RESUSCITATION
• Common Device Name: CARDIAC CHEST COMPRESSOR
• Manufacturer (Section D): ZOLL CIRCULATION; 2000 ringwood ave.; san jose CA 95131
• MDR Report Key: 9649431
• Report Number: 3010617000-2020-00110
• Device Sequence Number: 16777972
• Product Code: DRM
• UDI-Device Identifier: 00849111000192
• UDI-Public: 00849111000192
• Combination Product (Y/N): N
• Initial Reporter Country: RS
• PMA/510(K) Number: K112998
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: company representative,foreig
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial
• Report Date (Section B): 01/30/2020

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 Number: MODEL 100
• Device Catalogue Number: 8700-0700-29
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 01/03/2020
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 01/09/2020
• Initial Report FDA Received Date: 01/30/2020
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1