MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-01-07 for AUTOPULSE? LI-ION BATTERY MODEL 100 8700-0752-01 manufactured by Zoll Circulation.
[179432042]
Zoll has not received the product for investigation. A follow-up report will be submitted when the product is returned and investigation has been completed.
Patient Sequence No: 1, Text Type: N, H10
[179432043]
During patient use, customer reported that about 5 minutes of autopulse platform use, it displayed "replace battery" message and powered off. Crew replaced the autopulse platform with a new battery to continue with compression. The crew did observed the autopulse li-ion battery (serial # (b)(4)) status as fully charged on the autopulse multi chemistry charger prior to insertion. No known impact or consequence to patient information was provided.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 3010617000-2020-00012 |
MDR Report Key | 9561833 |
Report Source | COMPANY REPRESENTATIVE,FOREIG |
Date Received | 2020-01-07 |
Date of Report | 2020-02-13 |
Date of Event | 2019-12-17 |
Date Mfgr Received | 2020-02-12 |
Device Manufacturer Date | 2018-02-21 |
Date Added to Maude | 2020-01-07 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | MS. KIM THOA NGUYEN |
Manufacturer Street | 2000 RINGWOOD AVE, |
Manufacturer City | SAN JOSE CA 95131 |
Manufacturer Country | US |
Manufacturer Postal | 95131 |
Manufacturer Phone | 4084192922 |
Manufacturer G1 | ZOLL CIRCULATION |
Manufacturer Street | 2000 RINGWOOD AVE. |
Manufacturer City | SAN JOSE CA 95131 |
Manufacturer Country | US |
Manufacturer Postal Code | 95131 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | AUTOPULSE? LI-ION BATTERY |
Generic Name | LI-ION BATTERY, RECHARGEABLE |
Product Code | MOQ |
Date Received | 2020-01-07 |
Returned To Mfg | 2020-01-08 |
Model Number | MODEL 100 |
Catalog Number | 8700-0752-01 |
Operator | HEALTH PROFESSIONAL |
Device Availability | Y |
Device Age | DA |
Device Eval'ed by Mfgr | Y |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | ZOLL CIRCULATION |
Manufacturer Address | 2000 RINGWOOD AVE. SAN JOSE CA 95131 US 95131 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2020-01-07 |