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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDIVANCE, INC. ¿ 1725056 ARCTIC SUN® TEMPERATURE MANAGEMENT SYSTEM, TEMPERATURE CABLE NELLCOR

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MEDIVANCE, INC. ¿ 1725056 ARCTIC SUN® TEMPERATURE MANAGEMENT SYSTEM, TEMPERATURE CABLE NELLCOR Back to Search Results
Catalog Number 735-02
Medical Device Problem Code Material Split, Cut or Torn (4008)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/19/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The investigation is still in progress.Once the investigation is complete a supplemental report will be filed.Complete initial reporter phone number: (b)(6).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.
 
Event or Problem Description
It was reported that the arctic sun device screen had no display.Per sample evaluation results on 19aug2025, temperature in cable-nellcor was damaged.Fill tube was clogged.
 
Additional Manufacturer Narrative
The reported issue was confirmed.The root cause of the reported issue could not be determined.During evaluation, it was confirmed that the temperature in cable was replaced.Temperature cable was replaced.The device passed all tests and is ready for use.The instructions-for-use are found to be adequate.The ifu currently instructs the user on the proper method to use this device to avoid undue injury to the patient and damage to the product.A dhr is not required as the serial number is unknown.Based on the results of the investigation, no additional actions can be taken.Correction: d,h 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.
 
Event or Problem Description
It was reported that the arctic sun device screen had no display.Per sample evaluation results on (b)(6) 2025, temperature in cable-nellcor was damaged.Fill tube was clogged.
 
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Brand Name
ARCTIC SUN® TEMPERATURE MANAGEMENT SYSTEM, TEMPERATURE CABLE NELLCOR
Common Device Name
TEMPERATURE CABLE
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, GA 30014
7707846100
MDR Report Key22885175
Report Number1018233-2025-07028
Device Sequence Number18340512
Product Code DWJ
UDI-Device Identifier00801741080296
UDI-Public(01)00801741080296
Combination Product (Y/N)N
Initial Reporter CountryCH
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) 12/19/2025
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 Number735-02
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/19/2025
Supplement Date Received by Manufacturer12/19/2025
Initial Report FDA Received Date08/25/2025
Supplement Report FDA Received Date01/07/2026
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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