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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHYSIO-CONTROL, INC. - 3015876 LIFEPAK® CR PLUS DEFIBRILLATOR; AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE)

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PHYSIO-CONTROL, INC. - 3015876 LIFEPAK® CR PLUS DEFIBRILLATOR; AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE) Back to Search Results
Model Number CRPLUS
Medical Device Problem Codes Defibrillation/Stimulation Problem (1573); Power Problem (3010)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/02/2022
Type of Reportable Event Malfunction
Event or Problem Description
The customer contacted stryker to report that their device was showing all three icons (attention, charge-pak and service wrench).With all three icons illuminated, the device may not have sufficient power available to deliver effective defibrillation therapy to a patient if it was needed.There was no patient involvement reported during the event.
 
Additional Manufacturer Narrative
Stryker continues to investigate the reported failure and will submit a supplemental report on this event to the fda as provided by 21 cfr 803.56.
 
Additional Manufacturer Narrative
Stryker evaluated the customer's device and confirmed the reported issue of the device not powering on and showing three illuminated icons in the readiness display.Stryker determined the cause of the reported issue to be the expired charge-pak.Stryker archived the device, and the customer received a replacement device.
 
Event or Problem Description
The customer contacted stryker to report that their device was showing all three icons (attention, charge-pak and service wrench).With all three icons illuminated, the device may not have sufficient power available to deliver effective defibrillation therapy to a patient if it was needed.There was no patient involvement reported during the event.
 
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Brand Name
LIFEPAK® CR PLUS DEFIBRILLATOR
Common Device Name
AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE)
Manufacturer (Section D)
PHYSIO-CONTROL, INC. - 3015876
11811 willows road ne
redmond WA 98052
Manufacturer (Section G)
PHYSIO-CONTROL, INC. - 3015876
11811 willows road ne
redmond WA 98052
Manufacturer Contact
todd bandy
11811 willows road ne
redmond, WA 98052
4258674000
MDR Report Key15835495
Report Number0003015876-2022-02564
Device Sequence Number20180942
Product Code MKJ
UDI-Device Identifier00883873820551
UDI-Public00883873820551
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
K033275
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 01/27/2023
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 Lay User/Patient
Device Model NumberCRPLUS
Device Catalogue Number99403-000156
Was Device Available for Evaluation? Device Returned to Manufacturer
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 11/02/2022
Supplement Date Received by Manufacturer01/20/2023
Initial Report FDA Received Date11/21/2022
Supplement Report FDA Received Date01/27/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/20/2014
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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