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U.S. Department of Health and Human Services

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

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PHYSIO-CONTROL, INC. - 3015876 LIFEPAK(R) 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 12/05/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
A stryker service representative performed an initial evaluation of the customer¿s device and concluded that the device can not be repaired.The customer will receive a replacement device.Stryker continues to investigate the reported issue and will submit a supplemental report on this event to the fda as provided by 21 cfr 803.56.
 
Event or Problem Description
The customer contacted stryker to report that that their device does not power on when the lid is opened. in this state the device may not be able to deliver defibrillation therapy, if needed.There was no patient use associated with the reported event.
 
Additional Manufacturer Narrative
Section d4 lot/serial no.Of initial mdr indicates: (b)(6).Section d4 lot/serial no.Of initial mdr should indicate: (b)(6).The product assessment center (pac) technician evaluated the device and was not able to duplicate the reported issue.The device log was cleared prior to being received into pac, therefore the device log analysis is not available.A root cause of the reported issue could not be determined.
 
Event or Problem Description
The customer contacted stryker to report that that their device does not power on when the lid is opened.In this state the device may not be able to deliver defibrillation therapy, if needed.There was no patient use associated with the reported event.
 
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Brand Name
LIFEPAK(R) 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
brian blakeslee
11811 willows road ne
redmond, WA 98052
4258674000
MDR Report Key18470641
Report Number0003015876-2024-00048
Device Sequence Number6426574
Product Code MKJ
UDI-Device Identifier00883873824078
UDI-Public00883873824078
Combination Product (Y/N)N
Initial Reporter StateVA
Initial Reporter CountryUS
PMA/510(K) Number
P170018
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) 08/13/2024
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 Lay User/Patient
Device Model NumberCR2
Device Catalogue Number99512-001267
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/04/2024
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 12/19/2023
Supplement Date Received by Manufacturer08/12/2024
Initial Report FDA Received Date01/08/2024
Supplement Report FDA Received Date08/13/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/08/2020
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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