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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHYSIO-CONTROL, INC. - 3015876 LIFEPAK® CR2 DEFIBRILLATOR; AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE)

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PHYSIO-CONTROL, INC. - 3015876 LIFEPAK® CR2 DEFIBRILLATOR; AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE) Back to Search Results
Model Number CR2
Medical Device Problem Code Failure to Power Up (1476)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/09/2023
Type of Reportable Event Malfunction
Event or Problem Description
The customer contacted stryker to report that their device does not turn on as expected when opening the lid.This can lead to a use error resulting in a failure to deliver defibrillation.There was no patient involvement reported with the event.
 
Additional Manufacturer Narrative
Stryker evaluated the customer's device and verified the reported issue.The customer will receive a replacement device to resolve 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 evaluated the customer¿s device and verified the reported issue.Stryker determined that the cause of the reported issue was due to a faulty reed switch sw5.This device was archived by stryker.
 
Event or Problem Description
The customer contacted stryker to report that their device does not turn on as expected when opening the lid.This can lead to a use error resulting in a failure to deliver defibrillation.There was no patient involvement reported with the event.
 
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Brand Name
LIFEPAK® CR2 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 Key17694511
Report Number0003015876-2023-01607
Device Sequence Number6434704
Product Code MKJ
UDI-Device Identifier00883873824085
UDI-Public00883873824085
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
P160026
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) 09/12/2023
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 NumberCR2
Device Catalogue Number99512-001266
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/24/2023
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 08/09/2023
Supplement Date Received by Manufacturer09/07/2023
Initial Report FDA Received Date09/06/2023
Supplement Report FDA Received Date09/12/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/17/2022
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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