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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHYSIO-CONTROL, INC. - 3015876 LIFEPAK® 20E DEFIBRILLATOR/MONITOR; AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE)

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PHYSIO-CONTROL, INC. - 3015876 LIFEPAK® 20E DEFIBRILLATOR/MONITOR; AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE) Back to Search Results
Model Number 20E
Medical Device Problem Codes Failure to Power Up (1476); Key or Button Unresponsive/not Working (4063)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/10/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Stryker evaluated the customer's device and was able to verify the reported issue.Stryker also observed that the device would not be able to power on with dc power only.Stryker replaced the device's power supply, power pcb, and a07 main battery to resolve the reported issue.After completing other unrelated repairs, proper device operation was observed through functional and performance testing and the device returned to the customer for use.Stryker product analysis center (pac) determined the use of oem battery pack was causing the issue.Labeling on the battery itself states that this battery should not be used on devices made after 2018 and this device was manufactured in 2019.
 
Event or Problem Description
The customer contacted stryker to report that their device's on button intermittently unresponsive.During evaluation, stryker observed the device did not power on.In this state the device would be inoperable and defibrillation therapy would not be available if needed.There was no patient involvement reported with the event.
 
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Brand Name
LIFEPAK® 20E DEFIBRILLATOR/MONITOR
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 Key18280429
Report Number0003015876-2023-02308
Device Sequence Number5910234
Product Code MKJ
UDI-Device Identifier00883873852804
UDI-Public00883873852804
Combination Product (Y/N)N
Initial Reporter StateWI
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
Report Date (Section B) 12/07/2023
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 Health Professional
Device Model Number20E
Device Catalogue Number99507-000132
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/17/2023
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 11/10/2023
Initial Report FDA Received Date12/07/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/26/2019
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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