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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 Code Failure to Power Up (1476)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/18/2022
Type of Reportable Event Malfunction
Event or Problem Description
The customer contacted stryker to report that their device failed to power on.In this state, the device may not be able to deliver defibrillation therapy if 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 verified the reported issue.Stryker determined that the cause of the reported issue was the on/off switch.Stryker archived the device and the customer received a replacement device.
 
Event or Problem Description
The customer contacted stryker to report that their device failed to power on.In this state, the device may not be able to deliver defibrillation therapy if 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 Key15937063
Report Number0003015876-2022-02658
Device Sequence Number17706594
Product Code MKJ
UDI-Device Identifier00883873820551
UDI-Public00883873820551
Combination Product (Y/N)N
Initial Reporter StateFL
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 11/18/2022
Supplement Date Received by Manufacturer01/24/2023
Initial Report FDA Received Date12/07/2022
Supplement Report FDA Received Date01/27/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/20/2017
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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