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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 02/06/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
A stryker service representative performed an initial evaluation of the customer¿s device and verified that the device would not power on with ac power only.The device was still able to power on with dc power.After replacing power pcb assembly, proper device operation was observed through functional and performance testing.The device was subsequently returned to the customer.
 
Event or Problem Description
The customer contacted stryker to report that their device failed to power on.In this state the device may not be able to provide defibrillation therapy, if it were needed.There was no report of patient use associated with the reported event.
 
Additional Manufacturer Narrative
Stryker further evaluated the replaced part at the product analyses center (pac) and confirmed that a shorted transistor on the eos is causing the issue of no ac operation and no dc battery charge.The technician was unable to replicate the issue of no dc operation during testing the power pcb assembly.
 
Event or Problem Description
The customer contacted stryker to report that their device failed to power on.In this state the device may not be able to provide defibrillation therapy, if it were needed.There was no report of 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 Key18833970
Report Number0003015876-2024-00481
Device Sequence Number7294355
Product Code MKJ
UDI-Device Identifier00883873852798
UDI-Public00883873852798
Combination Product (Y/N)N
Initial Reporter StateTX
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) 08/22/2024
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 Manufacturer02/29/2024
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/06/2024
Supplement Date Received by Manufacturer07/25/2024
Initial Report FDA Received Date03/04/2024
Supplement Report FDA Received Date08/22/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/27/2021
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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