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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHYSIO-CONTROL, INC. - 3015876 LIFEPAK 1000 DEFIBRILLATOR; AUTOMATIC EXTERNAL DEFIBRILLATOR

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PHYSIO-CONTROL, INC. - 3015876 LIFEPAK 1000 DEFIBRILLATOR; AUTOMATIC EXTERNAL DEFIBRILLATOR Back to Search Results
Model Number 1000
Medical Device Problem Code Power Problem (3010)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/01/2025
Type of Reportable Event Malfunction
Event or Problem Description
The customer contacted stryker to report that their device's battery port is damaged.In this state the user cannot insert the battery and the device may not be able to deliver defibrillation therapy if needed.There was no patient involvement reported with the event.
 
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.
 
Additional Manufacturer Narrative
The device was not returned to stryker evaluation.The reported issue could not be verified.The cause could not be determined.
 
Event or Problem Description
The customer contacted stryker to report that their device's battery port is damaged.In this state the user cannot insert the battery and the device may not be able to deliver defibrillation therapy if needed.There was no patient involvement reported with the event.
 
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Brand Name
LIFEPAK 1000 DEFIBRILLATOR
Common Device Name
AUTOMATIC EXTERNAL DEFIBRILLATOR
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 Key21885873
Report Number0003015876-2025-00800
Device Sequence Number3442770
Product Code MKJ
UDI-Device Identifier00883873815458
UDI-Public00883873815458
Combination Product (Y/N)N
Initial Reporter StateAL
Initial Reporter CountryUS
PMA/510(K) Number
K122600
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) 08/13/2025
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 Number1000
Device Catalogue Number99425-000023
Was Device Available for Evaluation? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 04/01/2025
Supplement Date Received by Manufacturer08/06/2025
Initial Report FDA Received Date04/22/2025
Supplement Report FDA Received Date08/13/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/10/2014
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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