MAUDE Adverse Event Report: MEDIVANCE, INC. ¿ 1725056 ARCTIC SUN® TEMPERATURE MANAGEMENT SYSTEM, POWER CORD; ARCTIC SUN POWER CORD

Catalog Number	733-03
Medical Device Problem Codes	Circuit Failure (1089); Power Problem (3010)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	11/13/2023
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that the water temperature dropped out and patient temperature plummeted on the back of this in an arctic sun device.This happened twice during the rewarm phase of therapy.Per sample evaluation results on 13nov2023, it was reported that the arctic sun device failed the protective earth during est due to high resistance.
Additional 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.
Additional Manufacturer Narrative
Upon further review, bd has determined that this mdr is not reportable.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 or Problem Description
It was reported that the water temperature dropped out and patient temperature plummeted on the back of this in an arctic sun device.This happened twice during the rewarm phase of therapy.Per sample evaluation results on (b)(6) 2023, it was reported that the arctic sun device failed the protective earth during est due to high resistance.
Additional Manufacturer Narrative
The reported issue was confirmed.The root cause of the reported issue is a failed power cord.The device was evaluated upon receipt.Device failed the protective earth during est due to high resistance.Replaced power cord.Est completed successfully.The serial number is unknown; therefore, the device history record could not be reviewed.The labelling review is not required as the complaint or reported issue was confirmed through other elements of the investigation to not be labeling or packaging related.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 or Problem Description
It was reported that the water temperature dropped out and patient temperature plummeted on the back of this in an arctic sun device.This happened twice during the rewarm phase of therapy.Per sample evaluation results on 13nov2023, it was reported that the arctic sun device failed the protective earth during est due to high resistance.
Additional Manufacturer Narrative
The reported issue was confirmed.The root cause of the reported issue is a failed power cord.The device was evaluated upon receipt.Device failed the protective earth during est due to high resistance.Replaced power cord.Est completed successfully.The serial number is unknown; therefore, the device history record could not be reviewed.The labelling review is not required as the complaint or reported issue was confirmed through other elements of the investigation to not be labeling or packaging related.Udi related data quality updates only udi format updated with available product information per gudid as requested.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 or Problem Description
It was reported that the water temperature dropped out and patient temperature plummeted on the back of this in an arctic sun device.This happened twice during the rewarm phase of therapy.Per sample evaluation results on 13nov2023, it was reported that the arctic sun device failed the protective earth during est due to high resistance.

• Brand Name: ARCTIC SUN® TEMPERATURE MANAGEMENT SYSTEM, POWER CORD
• Common Device Name: ARCTIC SUN POWER CORD
• 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 Key: 18237367
• Report Number: 1018233-2023-08647
• Device Sequence Number: 14253376
• Product Code: DWJ
• UDI-Device Identifier: 00801741080258
• UDI-Public: (01)00801741080258
• Combination Product (Y/N): N
• Initial Reporter Country: AS
• PMA/510(K) Number: K161602
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other,Health Professional,User Facility
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup,Followup
• Report Date (Section B): 08/07/2024

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 Catalogue Number: 733-03
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 09/01/2023
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 11/13/2023
• Supplement Date Received by Manufacturer: 12/28/2023; 01/12/2024; 08/07/2024
• Initial Report FDA Received Date: 11/30/2023
• Supplement Report FDA Received Date: 01/05/2024; 01/18/2024; 08/11/2024
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• 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 Number: 1
• Outcome Attributed to Adverse Event: Other
• Patient Sex: Unknown