MAUDE Adverse Event Report: DJO, LLC CHATTANOOGA THERATHERM MOIST HEAT 14X27STD; PAD, HEATING, POWERED

Model Number	1032
Medical Device Problem Code	Overheating of Device (1437)
Health Effect - Clinical Code	No Known Impact Or Consequence To Patient (2692)
Date of Event	07/17/2019
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
No device was returned for evaluation.If the device is received, a follow-up report will be submitted upon completion of product evaluation.
Event or Problem Description
It was reported that the heating pad keeps heating even over the set up temp.There was no reported adverse event.No further information has been provided.

• Brand Name: CHATTANOOGA THERATHERM MOIST HEAT 14X27STD
• Common Device Name: PAD, HEATING, POWERED
• Manufacturer (Section D): DJO, LLC; 1430 decision street; vista CA 92081 9663
• MDR Report Key: 8892400
• Report Number: 2020737-2019-00009
• Device Sequence Number: 1617750
• Product Code: IRT
• UDI-Device Identifier: 00888912000147
• UDI-Public: 00888912000147
• Combination Product (Y/N): N
• Initial Reporter Country: CA
• PMA/510(K) Number: K770686
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: distributor,foreign
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 08/13/2019

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: Lay User/Patient
• Device Model Number: 1032
• Device Lot Number: 170210320531
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 07/17/2019
• Initial Report FDA Received Date: 08/14/2019
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1