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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHYSIO-CONTROL, INC. - 3015876 LIFEPAK(R) 15 MONITOR/DEFIBRILLATOR; AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE)

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PHYSIO-CONTROL, INC. - 3015876 LIFEPAK(R) 15 MONITOR/DEFIBRILLATOR; AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE) Back to Search Results
Model Number 15
Medical Device Problem Code Failure to Power Up (1476)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/12/2024
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 therapy would not be available, if needed.There was no patient use associated with the reported event.
 
Additional Manufacturer Narrative
Stryker evaluated the customer's device and verified the reported issue.After replacing the user interface pcb assembly and performing other unrelated repairs, proper device operation was observed through functional and performance testing.The device was subsequently returned to the customer for use.
 
Additional Manufacturer Narrative
Stryker product analysis center (pac) further evaluated the customer's device and was unable to duplicate the reported issue.Further root cause could not be determined.
 
Event or Problem Description
A customer contacted stryker to report that their device would not power on.As a result, 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(R) 15 MONITOR/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 Key18886540
Report Number0003015876-2024-00529
Device Sequence Number3051531
Product Code MKJ
UDI-Device Identifier00883873871829
UDI-Public00883873871829
Combination Product (Y/N)N
Initial Reporter StateCO
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) 05/10/2024
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 Number15
Device Catalogue Number99577-001944
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/06/2024
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 02/12/2024
Supplement Date Received by Manufacturer04/19/2024
Initial Report FDA Received Date03/12/2024
Supplement Report FDA Received Date05/10/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/18/2023
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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