BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PHILIPSSONICARE

    MDR report key: 11158054 · Received January 12, 2021

    Report

    Report Number
    3026630-2021-00005
    Event Type
    Injury
    Date Received
    January 12, 2021
    Date of Event
    November 30, 2020
    Manufacturer
    PHILIPS ORAL HEALTHCARE, LLC
    Product Code
    JEQ
    PMA / PMN Number
    EXEMPT
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 0

    D4: THE PRODUCT MODEL WAS IDENTIFIED AND UPDATED. ANALYSIS RESULTS: FAILURE ANALYSIS OF THE RETURNED PRODUCT (PERFORMED AT PHILIPS ORAL HEALTHCARE) IDENTIFIED THAT THE ROOT CAUSE WAS A DEFORMED CHARGER DUE TO CUSTOMER MISUSE.

    Additional Manufacturer Narrative · 1

    THE EVENT DATE IS APPROXIMATE. THE PRODUCT MODEL, CATALOG NUMBER, SERIAL NUMBER, LOT NUMBER, AND UDI WERE NOT PROVIDED. A PARTIAL SERIAL NUMBER WAS DETERMINED FROM PHOTOS PROVIDED BY THE CONSUMER. REPORT SOURCE: THE COMPLAINT WAS RECEIVED FROM A CONSUMER IN (B)(6).

    Description of Event or Problem · 1

    A CONSUMER REPORTED THAT THEIR PHILIPS CHARGER CAUGHT FIRE. NO SERIOUS INJURIES OR PROPERTY DAMAGE WERE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    49741 PHILIPSSONICARE SONICARE CHARGER JEQ PHILIPS ORAL HEALTHCARE, LLC 420303553940

    Patients

    Seq Age Sex Outcome Treatment
    1