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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 01/04/2024
Type of Reportable Event Malfunction
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.
 
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.
 
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 performed an evaluation of the customer's device and was able to verify and duplicate the reported issue for the ac operation.The stryker technician was not able to duplicate the issue with the dc operation; the stryker technician was able to power on the device using a known good dc battery.The stryker technician replaced the power supply (eos) and the power pcb assembly from the power module to resolve the issue.After observing proper device operation through functional and performance testing, the device was returned to the customer for use.The removed part was further evaluated by stryker product analysis center (pac).The pac technician confirmed a shorted transistor on the eos.The root cause for no ac operation was determined to be a shorted transistor on the eos.No root cause was determined for no dc operation.
 
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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 Key18562732
Report Number0003015876-2024-00159
Device Sequence Number20514816
Product Code MKJ
UDI-Device Identifier00883873852804
UDI-Public00883873852804
Combination Product (Y/N)N
Initial Reporter StateIN
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) 04/26/2024
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 Number99507-000132
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/16/2024
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 01/04/2024
Supplement Date Received by Manufacturer04/08/2024
Initial Report FDA Received Date01/23/2024
Supplement Report FDA Received Date04/26/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/24/2021
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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