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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP HUDSON RCI; AQUATHERM III HEATER,ADJUST,LVN

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MEDLINE INDUSTRIES, LP HUDSON RCI; AQUATHERM III HEATER,ADJUST,LVN Back to Search Results
Catalog Number HUD05014
Medical Device Problem Code Insufficient Heating (1287)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/20/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Per report, "customer called in stating the items is not heating up." due diligence has been completed.Despite good faith efforts to obtain additional information, the customer contact was unable or unwilling to provide further incident details to the manufacturer.There were no reports of death, serious injury, medical intervention, or follow up care.It has been determined that the reported event could cause or contribute to serious injury if it were to occur again.In an abundance of caution, this medwatch is being filed.If any further relevant information is identified or obtained, a supplemental medwatch will be submitted.
 
Event or Problem Description
Per report, "customer called in stating the items is not heating up." due diligence has been completed.Despite good faith efforts to obtain additional information, the customer contact was unable or unwilling to provide further incident details to the manufacturer.There were no reports of death, serious injury, medical intervention, or follow up care.It has been determined that the reported event could cause or contribute to serious injury if it were to occur again.In an abundance of caution, this medwatch is being filed.If any further relevant information is identified or obtained, a supplemental medwatch will be submitted.
 
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Brand Name
HUDSON RCI
Common Device Name
AQUATHERM III HEATER,ADJUST,LVN
Manufacturer (Section D)
MEDLINE INDUSTRIES, LP
three lakes drive
northfield IL 60093 2753
Manufacturer Contact
sipara semu
three lakes drive
northfield, IL 60093-2753
MDR Report Key25460651
Report Number1417592-2026-01463
Device Sequence Number8753660
Product Code CAF
UDI-Device Identifier10197344011629
UDI-Public10197344011629
Combination Product (Y/N)N
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
K223100
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 06/10/2026
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 Catalogue NumberHUD05014
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/20/2026
Initial Report FDA Received Date06/10/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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