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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHYSIO-CONTROL, INC. - 3015876 LIFEPAK 20E DEFIBRILLATOR/MONITOR; AUTOMATIC EXTERNAL DEFIBRILLATOR

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PHYSIO-CONTROL, INC. - 3015876 LIFEPAK 20E DEFIBRILLATOR/MONITOR; AUTOMATIC EXTERNAL DEFIBRILLATOR Back to Search Results
Model Number 20E
Medical Device Problem Code Key or Button Unresponsive/not Working (4063)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/01/2025
Type of Reportable Event Malfunction
Event or Problem Description
The customer contacted stryker to report that their device's controls were unresponsive.In this state the device may not be able to deliver defibrillation therapy if needed.There was no patient involvement reported with the event.
 
Additional Manufacturer Narrative
The customer was advised that due to the age of the device, stryker is unable to service it.The device was not returned to stryker.The cause of the reported issue can not be determined.
 
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Brand Name
LIFEPAK 20E DEFIBRILLATOR/MONITOR
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 Key22629639
Report Number0003015876-2025-01506
Device Sequence Number7989665
Product Code MKJ
UDI-Device Identifier00883873813805
UDI-Public00883873813805
Combination Product (Y/N)N
Initial Reporter StateWI
Initial Reporter CountryUS
PMA/510(K) Number
K130454
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
Report Date (Section B) 07/28/2025
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 Health Professional
Device Model Number20E
Device Catalogue Number99507-000010
Was Device Available for Evaluation? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 07/01/2025
Initial Report FDA Received Date07/28/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/22/2011
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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