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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 04/03/2023
Type of Reportable Event Malfunction
Event or Problem Description
The customer contacted stryker to report that their device did not 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
A stryker service representative performed an initial evaluation of the customer¿s device and was able to verify the reported issue.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 further evaluated the customer's device and determined that the cause of the reported issue was due to the depletion of the device's internal hybrid layer capacitor (hlc) batteries.Stryker archived the device, and the customer received a replacement.
 
Event or Problem Description
The customer contacted stryker to report that their device did not 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
dara friedman
11811 willows road ne
redmond, WA 98052
4258674000
MDR Report Key16811535
Report Number0003015876-2023-00750
Device Sequence Number11502951
Product Code MKJ
UDI-Device Identifier00883873820551
UDI-Public00883873820551
Combination Product (Y/N)N
Initial Reporter CountryCA
PMA/510(K) Number
K033275
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 08/28/2023
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 04/03/2023
Supplement Date Received by Manufacturer08/07/2023
Initial Report FDA Received Date04/25/2023
Supplement Report FDA Received Date08/28/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/28/2013
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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