AUTOPULSE? LI-ION BATTERY MODEL 100 8700-0752-01

MAUDE Adverse Event Report

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.

Event Text Entries

[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


MAUDE Entry Details

Report Number3010617000-2020-00012
MDR Report Key9561833
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-01-07
Date of Report2020-02-13
Date of Event2019-12-17
Date Mfgr Received2020-02-12
Device Manufacturer Date2018-02-21
Date Added to Maude2020-01-07
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. KIM THOA NGUYEN
Manufacturer Street2000 RINGWOOD AVE,
Manufacturer CitySAN JOSE CA 95131
Manufacturer CountryUS
Manufacturer Postal95131
Manufacturer Phone4084192922
Manufacturer G1ZOLL CIRCULATION
Manufacturer Street2000 RINGWOOD AVE.
Manufacturer CitySAN JOSE CA 95131
Manufacturer CountryUS
Manufacturer Postal Code95131
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameAUTOPULSE? LI-ION BATTERY
Generic NameLI-ION BATTERY, RECHARGEABLE
Product CodeMOQ
Date Received2020-01-07
Returned To Mfg2020-01-08
Model NumberMODEL 100
Catalog Number8700-0752-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerZOLL CIRCULATION
Manufacturer Address2000 RINGWOOD AVE. SAN JOSE CA 95131 US 95131


Patients

Patient NumberTreatmentOutcomeDate
10 2020-01-07

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