BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    WATER PIK

    MDR report key: 2359418 · Received November 22, 2011

    Report

    Report Number
    MW5023296
    Event Type
    Malfunction
    Date Received
    November 22, 2011
    Date of Event
    September 28, 2011
    Report Date
    September 28, 2011
    Manufacturer
    WATER PIK
    Product Code
    EFS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CONSUMER STATED THAT THE WATER FLOSSER CONTINUOUSLY TRIPS THE BREAKER WHICH MEANS THAT THE PRODUCT IS FAULTY AND COULD CAUSE ELECTROCUTION. THIS PRODUCT IS USED WITH ELECTRICITY AND WATER. ON (B)(6) 2011 CONSUMER STATED THAT HE CONTACTED THE MANUFACTURER AND WAS ADVISED THAT THERE WERE AWARE OF THE PROBLEM AND HAD A SOLUTION, AND HE WAS ALSO ADVISED TO USE A SURGE SUPPRESSOR. CONSUMER FEELS THAT THERE IS LEAKAGE OF ELECTRICITY IN THIS PRODUCT WHICH IS VERY UNSAFE AND SHOULD BE INVESTIGATED. RETAILER: (B)(4). . PURCHASE DATE: (B)(6) 2011 (THIS DATE IS AN ESTIMATE). THE PRODUCT WAS NOT DAMAGED BEFORE THE INCIDENT. THE PRODUCT WAS NOT MODIFIED BEFORE THE INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WATER PIK WATER FLOSSER EFS WATER PIK WP-100/450

    Patients

    Seq Age Sex Outcome Treatment
    1