MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; NEPTUNE HEATED HUMIDIFIER,CONCHASMART

Catalog Number	HUD42500
Medical Device Problem Code	Break (1069)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	02/21/2024
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that "the unit is broken".
Additional Manufacturer Narrative
It was reported finding that "the unit is malfunctioning/broken".A sample was received for investigation; the unit was visually inspected and found in good condition, connected for further testing, powered on with a confirmed red/yellow indicator flash, brought out of standby mode with a successful self-check, passed the temperature display accuracy test, and was tested for an extended period of time at different humidity levels and temperatures with no issue or alarms.Medline was not able to confirm the quality issue with the neptune heated humidifier, and the cause code was unconfirmed defect, not confirmed with received sample.No root cause was identified; the unit operated per specifications during the test and the quality team will monitor this issue for trending purposes.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 is a reportable event.If additional information becomes available this report will be reopened and reevaluated.This medical device report (mdr) is being submitted as part of retrospective review activities, which include review of historical data in accordance with regulations at 21 cfr part 803.The information included in this mdr reflects the information reasonably known to the manufacturer at the time of this retrospective review and submission.

• Brand Name: MEDLINE
• Common Device Name: NEPTUNE HEATED HUMIDIFIER,CONCHASMART
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield IL 60093 -275
• Manufacturer Contact: venkat gaanuthula ; three lakes drive; northfield, IL 60093--275
• MDR Report Key: 50952341
• Report Number: 1417592-2026-55118
• Device Sequence Number: 9552250
• Product Code: BTT
• UDI-Device Identifier: 10197344010806
• UDI-Public: 10197344010806
• Combination Product (Y/N): N
• Initial Reporter State: CO
• Initial Reporter Country: US
• PMA/510(K) Number: K131912
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Type of Report: Initial
• Report Date (Section B): 09/29/2026

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 Number: HUD42500
• Was Device Available for Evaluation?: Yes
• Date Returned to Manufacturer: 02/28/2024
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 02/21/2024
• Initial Report FDA Received Date: 09/30/2026
• 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
• Patient Sequence Number: 1
• Patient Sex: Unknown