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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDIVANCE, INC. ¿ 1725056 ARCTIC SUN STAT; ARCTIC SUN DEVICE

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MEDIVANCE, INC. ¿ 1725056 ARCTIC SUN STAT; ARCTIC SUN DEVICE Back to Search Results
Catalog Number 60000000
Device Problem Insufficient Heating (1287)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 03/28/2024
Event Type  malfunction  
Manufacturer Narrative
The reported issue was unconfirmed.The root cause of the reported issue could not be determined as the reported issue could not be reproduced.The reported event is unconfirmed, labeling/packaging review is not required.The reported event is unconfirmed, dhr review is not required.H11: section a through f - the information provided by bd represents all the known information at this time.Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.H3 other text : the actual/suspected device was inspected.
 
Event Description
It was reported that biomed stated the arctic sun device was sent down for not rewarming a patient, while they were troubleshooting, noticed that during the functional check the device was heating and cooling fine, but the bypass flow rate was not reaching a minimum of 1.5 lpm like it stated in the service manual, coming back for service under the service warranty.Per sample evaluation results on 12apr2024, it was reported that white powdery residue found around the o-ring sealing of the pressure transducer.
 
Manufacturer Narrative
The investigation is still in progress.Once the investigation is complete a supplemental report will be filed.H11: section a through f - the information provided by bd represents all the known information at this time.Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.
 
Event Description
It was reported that biomed stated the arctic sun device was sent down for not rewarming a patient, while they were troubleshooting, noticed that during the functional check the device was heating and cooling fine, but the bypass flow rate was not reaching a minimum of 1.5 lpm like it stated in the service manual, coming back for service under the service warranty.Per sample evaluation results on 12apr2024, it was reported that white powdery residue found around the o-ring sealing of the pressure transducer.
 
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Brand Name
ARCTIC SUN STAT
Type of Device
ARCTIC SUN DEVICE
Manufacturer (Section D)
MEDIVANCE, INC. ¿ 1725056
321 s taylor ave
suite 200
louisville 80027
Manufacturer (Section G)
MEDIVANCE, INC. ¿ 1725056
321 s taylor ave
suite 200
louisville 80027
Manufacturer Contact
xeeroy rada
8195 industrial blvd
covington 30014
7707846100
MDR Report Key19115841
MDR Text Key340525877
Report Number1018233-2024-02122
Device Sequence Number1
Product Code DWJ
UDI-Device Identifier00801741161513
UDI-Public(01)00801741161513
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K200225
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Health Professional,User Facility
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 04/16/2024
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
Device Operator Health Professional
Device Catalogue Number60000000
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/05/2024
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 03/28/2024
Initial Date FDA Received04/16/2024
Supplement Dates Manufacturer Received04/17/2024
Supplement Dates FDA Received04/17/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/06/2023
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
Patient Outcome(s) Other;
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