BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HEATING PAD

    MDR report key: 13109041 · Received December 29, 2021

    Report

    Report Number
    MW5106301
    Event Type
    Injury
    Date Received
    December 29, 2021
    Date of Event
    December 20, 2021
    Report Date
    December 26, 2021
    Manufacturer
    UNKNOWN
    Product Code
    IRT
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND
    Health Professional
    *

    Narratives

    Description of Event or Problem · 0

    ADDITIONAL INFORMATION RECEVIVED FOR REPORT MW5106301 ON 01/31/2022: MANUFACTURER IS UNKNOWN.

    Description of Event or Problem · 0

    MY MOTHER IN LAW WAS USING A (B)(6) SUNBEAM HEATING PAD MODEL 853608 WHEN IT CAUGHT FIRE. FLAMES ERUPTED NEAR HER HEAD. SHE YELLED AND MY FATHER IN LAW WAS ABLE TO RUN FROM THE NEXT ROOM AND WAS ABLE TO PUT IT OUT, BY PULLING IT OUT OF THE WALL PLUG AND STAMPING OUT THE FLAMES WITH HIS FOOT, JUST IN TIME. IT SINGED HER HAIR AND THE LEATHER SOFA, BUT SHE SURVIVED WITHOUT INJURY, OTHER THAN THE TRAUMA OF THIS HAPPENING. SHE IS NOT ABLE TO GET OUT OF A CHAIR SAFELY BY HERSELF SO IT WOULD HAVE BEEN LIFE THREATENING AND THE HOUSE WOULD HAVE BURNED DOWN IF MY FATHER IN LAW HAD NOT BEEN ABLE TO GET TO HER AND THE FIRE IN TIME. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2007610 HEATING PAD PAD, HEATING, POWERED IRT UNKNOWN PM02 853608

    Patients

    Seq Age Sex Outcome Treatment
    1 77 YR Female Required Intervention| O| L ANTI-SEIZURE MEDICATIONS| THYROID MEDICATION| WALKER | WHEELCHAIR