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U.S. Department of Health and Human Services

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

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MEDIVANCE, INC. ¿ 1725056 ARCTIC SUN® TEMPERATURE MANAGEMENT SYSTEM, FILL TUBE; ARCTIC SUN FILL TUBE Back to Search Results
Catalog Number 718-00
Medical Device Problem Code Improper or Incorrect Procedure or Method (2017)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/03/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The reported issue was confirmed.The root cause of the reported issue could not be identified.Although a root cause could not be definitively identified, based on the risk documentation review, a potential root cause for this type of failure could be not following cleaning, set up, disposal instructions causing unintentional damage to the device or accessories.However, there was insufficient information to confirm this potential root cause.Fill tube was dirty.Replaced fill tube.A dhr review is not required as the serial number is unknown.The instructions for use were found adequate and state the following: "cleaning and maintenance: routine cleaning and preventive maintenance should be performed on the arctic sun¿ temperature management system control module every 6 months at a minimum.This consists of cleaning the external surfaces, accessories and chiller condenser, inspecting the device, and replenishing the internal cleaning solution that suppresses microorganism growth in the water reservoir and hydraulic circuit.See the arctic sun¿ temperature management system service manual for additional information." 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 it was impossible to fill pump in arctic sun device.Per sample evaluation results received on 03jul2024, it was reported that the dirty fill tube noted in the depot repair findings.
 
Event or Problem Description
It was reported that it was impossible to fill pump in arctic sun device.Per sample evaluation results received on 03jul2024, it was reported that the dirty fill tube noted in the depot repair findings.
 
Additional Manufacturer Narrative
The reported issue was confirmed.The root cause of the reported issue could not be identified.Although a root cause could not be definitively identified, based on the risk documentation review, a potential root cause for this type of failure could be not following cleaning, set up, disposal instructions causing unintentional damage to the device or accessories.However, there was insufficient information to confirm this potential root cause.Fill tube was dirty.Replaced fill tube.A dhr review is not required as the serial number is unknown.The instructions for use were found adequate and state the following: "cleaning and maintenance: routine cleaning and preventive maintenance should be performed on the arctic sun¿ temperature management system control module every 6 months at a minimum.This consists of cleaning the external surfaces, accessories and chiller condenser, inspecting the device, and replenishing the internal cleaning solution that suppresses microorganism growth in the water reservoir and hydraulic circuit.See the arctic sun¿ temperature management system service manual for additional information." correction: d.Udi format updated with available product information per gudid.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.
 
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Brand Name
ARCTIC SUN® TEMPERATURE MANAGEMENT SYSTEM, FILL TUBE
Common Device Name
ARCTIC SUN FILL TUBE
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 Key19729494
Report Number1018233-2024-04186
Device Sequence Number18211470
Product Code DWJ
UDI-Device Identifier00801741080197
UDI-Public(01)00801741080197
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K161602
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Health Professional,User Facility
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 02/07/2025
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 Catalogue Number718-00
Device Lot NumberN/A
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/24/2024
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/03/2024
Supplement Date Received by Manufacturer02/07/2025
Initial Report FDA Received Date07/12/2024
Supplement Report FDA Received Date02/07/2025
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 Number1
Outcome Attributed to Adverse Event Other;
Patient SexUnknown
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