BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COMPASS HEALTH BRANDS

    MDR report key: 10704897 · Received October 20, 2020

    Report

    Report Number
    3012316249-2020-00032
    Event Type
    Injury
    Date Received
    October 20, 2020
    Date of Event
    June 3, 2020
    Report Date
    October 20, 2020
    Manufacturer
    DONGGUAN AIDISY MACHINERY & ELECTRONIC EQUIP.CO.
    Product Code
    CAF
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    PA, US
    Reporter Occupation
    003

    Narratives

    Description of Event or Problem · 1

    LETTER OF REPRESENTATION RECEIVED: CLAIMANT SUSTAINED PERSONAL INJURIES AS THE RESULT OF AN INCIDENT, WHEREBY OUR CLIENT USED THE PRODUCT AND WAS BURNED. AS A RESULT OF THIS INCIDENT, A CLAIM IS BEING MADE AGAINST YOUR INSURED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1168962 COMPASS HEALTH BRANDS NEBULIZER CAF DONGGUAN AIDISY MACHINERY & ELECTRONIC EQUIP.CO. NEB-RITE4

    Patients

    Seq Age Sex Outcome Treatment
    1 Other