BEUDAMED
    FDA Adverse Event Other Summary report: N

    VICKS

    MDR report key: 2974819 · Received February 13, 2013

    Report

    Report Number
    1314800-2013-00008
    Event Type
    Other
    Date Received
    February 13, 2013
    Date of Event
    January 29, 2013
    Report Date
    February 11, 2013
    Manufacturer
    KAZ INC
    Product Code
    KFZ
    PMA / PMN Number
    EXEMPT
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    THE CONSUMER REPORTED RECEIVING BURNS FROM THE HUMIDIFIER. SHE STATED SHE TILTED IT SLIGHTLY WHICH CAUSED BOILING WATER TO POUR ON HER CHEST AND STOMACH. THE INSTRUCTIONS FOR THE UNIT STATE TO ALWAYS USE ON A FIRM LEVEL SURFACE TO PREVENT THE TILTING OF THE UNIT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    64237 VICKS HUMIDIFIER KFZ KAZ INC V1200 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other