FDA Adverse Event Death Summary report: N

LIFEPAK(R) CR2 DEFIBRILLATOR

MDR report key: 17077453 · Received June 7, 2023

Report

Report Number
0003015876-2023-01043
Event Type
Death
Date Received
June 7, 2023
Date of Event
April 27, 2023
Report Date
July 28, 2023
Manufacturer
PHYSIO-CONTROL, INC. - 3015876
Product Code
MKJ
UDI-DI
00883873824139
PMA / PMN Number
P170018
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
DE, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE CUSTOMER PROVIDED STRYKER WITH ALL THE AVAILABLE PATIENT INFORMATION. PATIENT FIELDS IN WHICH INFORMATION WAS NOT PROVIDED WERE INTENTIONALLY LEFT BLANK. THE CUSTOMER RECEIVED A REPLACEMENT LID AND BATTERY. THE DEVICE OR THE LID WAS NOT RETURNED TO STRYKER FOR EVALUATION. THE ROOT CAUSE OF THE REPORTED ISSUE COULD NOT BE DETERMINED. STRYKER PERFORMED A CLINICAL REVIEW OF THE REPORTED EVENT AND IT WAS DETERMINED THAT IS UNKNOWN IF THE DEVICE CAUSED OR CONTRIBUTED TO THE REPORTED OUTCOME. THIS BECAUSE THE ECG WAS UNAVAILABLE, AND IT IS UNKNOWN IF THE PATIENT WAS IN A SHOCKABLE RHYTHM AT THE TIME OF THE EVENT. H3 OTHER TEXT : NOT RETURNED TO MANUFACTURER.

Additional Manufacturer Narrative · 0

STRYKER DETERMINED THAT THE DEVICE NOT POWERING ON AND THE READINESS INDICATOR NOT FLASHING WAS LIKELY CAUSED BY A DEPLETED BATTERY DUE TO THE MISSING MAGNET. THE ROOT CAUSE OF THE MISSING MAGNET COULD NOT BE DETERMINED.

Description of Event or Problem · 0

THE CUSTOMER CONTACTED STRYKER TO REPORT THAT THEIR DEVICE WOULD NOT POWER ON DURING A PATIENT EVENT. I ADDITION, THE CUSTOMER ADVISED THAT THEIR DEVICE WAS MISSING THE MAGNET FROM THE LID OF THE DEVICE. IN THIS STATE THE DEVICE WILL NOT TURN ON AUTOMATICALLY WHEN THE LID IS ACTIVATED, WHICH CAN CAUSE A DELAY IN DEFIBRILLATION THERAPY IF NEEDED OR MAY LEAD TO USE ERROR RESULTING IN A FAILURE TO DELIVER DEFIBRILLATION. ANOTHER DEVICE WAS LOCATED TO CONTINUE PATIENT CARE, HOWEVER, THE PATIENT DID NOT SURVIVE.

Description of Event or Problem · 0

THE CUSTOMER CONTACTED STRYKER TO REPORT THAT THEIR DEVICE WOULD NOT POWER ON DURING A PATIENT EVENT. I ADDITION, THE CUSTOMER ADVISED THAT THEIR DEVICE WAS MISSING THE MAGNET FROM THE LID OF THE DEVICE. IN THIS STATE THE DEVICE WILL NOT TURN ON AUTOMATICALLY WHEN THE LID IS ACTIVATED, WHICH CAN CAUSE A DELAY IN DEFIBRILLATION THERAPY IF NEEDED OR MAY LEAD TO USE ERROR RESULTING IN A FAILURE TO DELIVER DEFIBRILLATION. ANOTHER DEVICE WAS LOCATED TO CONTINUE PATIENT CARE, HOWEVER, THE PATIENT DID NOT SURVIVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1368305 LIFEPAK(R) CR2 DEFIBRILLATOR AUTOMATED EXTERNAL DEFIBRILLATORS (NON-WEARABLE) MKJ PHYSIO-CONTROL, INC. - 3015876 CR2 00883873824139

Patients

Seq Age Sex Outcome Treatment
1 Unknown Death