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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 Code Failure to Power Up (1476)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/05/2024
Type of Reportable Event Malfunction
Event or Problem Description
The customer contacted stryker to report that their device would not power on.In this state, the device would be inoperable and defibrillation therapy 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 issue 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.It was observed that the device did not have ac operation and the customer's battery was unable to power on the device.A known good battery was used for testing and the device was able to power.Stryker replaced the eos and power module to resolve the ac and battery charging issue.After observing proper device operation through functional and performance testing the unit was returned to the customer for use.The removed parts were further evaluated by stryker.Stryker confirmed an open fuse on the eos caused no ac operation and no battery charge.However, the cause of no dc operation could not be determined.
 
Event or Problem Description
The customer contacted stryker to report that their device would not power on.In this state, the device would be inoperable and defibrillation therapy would not be available if needed.There was no patient use associated with the reported 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
brian blakeslee
11811 willows road ne
redmond, WA 98052
4258674000
MDR Report Key18766998
Report Number0003015876-2024-00411
Device Sequence Number7795652
Product Code MKJ
UDI-Device Identifier00883873852798
UDI-Public00883873852798
Combination Product (Y/N)N
Initial Reporter StateMO
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) 04/02/2024
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 Manufacturer02/19/2024
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/05/2024
Supplement Date Received by Manufacturer04/01/2024
Initial Report FDA Received Date02/23/2024
Supplement Report FDA Received Date04/02/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/21/2022
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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