Fda tracking requirements, Notification of adverse events – ZOLL SurePower Rev B Charger Station User Manual

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9650-0535-01 Rev. B

FDA Tracking Requirements

U.S. Federal Law (21 CFR 821) requires the tracking of defibrillators. Under this law, owners
of this device must notify ZOLL Medical Corporation if this product is


lost, stolen, or destroyed

donated, resold, or otherwise distributed to a different organization

If any such event occurs, contact ZOLL Medical Corporation in writing with the following

1. Originator's organization – Company name, address, contact name, and contact phone



Part number, model number, and serial number of the device


Disposition of the device (for example, received, lost, stolen, destroyed, distributed to
another organization), new location and/or organization (if known and different from
originator’s organization) – company name, address, contact name, and contact phone


Date when the change took effect

Please address the information to:

ZOLL Medical Corporation
Attn: Tracking Coordinator
269 Mill Road
Chelmsford, MA 01824-4105

Fax: (978) 421-0025
Tel: (978) 421-9655

Notification of Adverse Events

As a health care provider, you may have responsibilities under the Safe Medical Devices Act
(SMDA) for reporting the occurrence of certain events to ZOLL Medical Corporation and
possibly, in the United States, to the Food and Drug Administration (FDA).

These events, described in 21 CFR Part 803, include device-related death and serious injury or
illness. In any event, as part of our Quality Assurance Program, ZOLL Medical Corporation
should be notified of any device failures or malfunctions. This information is required to ensure
that ZOLL Medical Corporation provides only the highest quality products.