BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HOLMES

    MDR report key: 3220641 · Received June 25, 2013

    Report

    Report Number
    3003862163-2013-00094
    Event Type
    Malfunction
    Date Received
    June 25, 2013
    Report Date
    June 25, 2013
    Manufacturer
    SUNBEAM PRODUCTS, INC., DBA JARDEN CONSUMER SOLUTIONS
    Product Code
    KFZ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    CONSUMER WAS SENT A PREPAID LABEL TO RETURN THE PRODUCT FOR EVALUATION, BUT THE CONSUMER HAS NOT RETURNED THE PRODUCT.

    Description of Event or Problem · 1

    CONSUMER ALLEGES A FLAME OCCURRED INSIDE THE HUMIDIFIER THEN EXTINGUISHED ITSELF. NO INJURIES OR PROPERTY DAMAGES WERE REPORTED WITH THIS INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    288582 HOLMES HUMIDIFIER KFZ SUNBEAM PRODUCTS, INC., DBA JARDEN CONSUMER SOLUTIONS HM5250 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1