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U.S. Department of Health and Human Services

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

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PHYSIO-CONTROL, INC. - 3015876 LIFEPAK(R) 20E DEFIBRILLATOR/MONITOR; AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE) Back to Search Results
Model Number 20E
Medical Device Problem Code Failure to Power Up (1476)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/04/2023
Type of Reportable Event Malfunction
Event or Problem Description
A customer contacted stryker to report that their device would not power on.As a result, defibrillation would not be available, if needed.There was no patient use associated with the reported 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 was able to duplicate the reported issue.Nevertheless, stryker was able to power on the device using a known good dc battery.Stryker replaced the eos and power pcba from the power module to repair device.After completing other unrelated repairs, proper device operation was observed through functional and performance testing.The device was returned to the customer for use.The product analysis center (pac) further evaluated the replaced parts.Pac confirmed that a shorted transistor on the eos was the cause of no ac operation and no dc battery charge.However, pac was not able to replicate issue of no dc operation testing the power pcba.Therefore, the root cause for no ac operation was determined to be an inoperative eos.No root cause was determined for no dc operation.
 
Event or Problem Description
A customer contacted stryker to report that their device would not power on.As a result, defibrillation would not be available, if needed.There was no patient use associated with the reported event.
 
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Brand Name
LIFEPAK(R) 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
brian blakeslee
11811 willows road ne
redmond, WA 98052
4258674000
MDR Report Key18382352
Report Number0003015876-2023-02480
Device Sequence Number7713394
Product Code MKJ
UDI-Device Identifier00883873852798
UDI-Public00883873852798
Combination Product (Y/N)N
Initial Reporter StateNJ
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) 01/17/2024
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 Number99507-000133
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/12/2023
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 12/04/2023
Supplement Date Received by Manufacturer01/09/2024
Initial Report FDA Received Date12/22/2023
Supplement Report FDA Received Date01/17/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/14/2022
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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