FDA Adverse Event Malfunction Summary report: N

EZ BREATHE ATOMIZER

MDR report key: 3251595 · Received July 24, 2013

Report

Report Number
1054871-2013-00061
Event Type
Malfunction
Date Received
July 24, 2013
Date of Event
June 27, 2013
Report Date
July 24, 2013
Manufacturer
HEALTH & LIFE (SUZHOU) CO., LTD.
Product Code
CCQ
Product Problem
Yes
Report Source
Distributor report
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

THE CUSTOMER CONTACTED NEPHRON PHARMACEUTICALS CORPORATION REGARDING A PRODUCT COMPLAINT ON (B)(6), 2013. HE REPORTED THAT A WASHER FELL FROM THE EZ BREATHE ATOMIZER ALONG WITH THE ASTHMANEFRIN INHALATION SOLUTION INTO HIS THROAT. HE REPORTED THAT HE ALSO EXPERIENCED THROAT IRRITATION AND WAS ADVISED BY A PHYSICIAN TO MONITOR HIS SYMPTOMS. THE INVESTIGATED PRODUCT FOR THE ENCLOSED MEDICAL DEVICE REPORT IS LISTED AMONG THE IMPLICATED LOTS FOR A NATIONWIDE RECALL INITIATED BY THE MANUFACTURER HEALTH & LIFT, CO., LTD., ON MAY 08, 2013. THE CLASS 1 RECALL (Z-1371-2013, Z-1372-2013, Z-1373-2013) WAS INITIATED AFTER NEPHRON PHARMACEUTICALS CORPORATION, THE IMPORTER, BECAME AWARE OF AN INCREASING NUMBER OF COMPLAINTS ASSOCIATED WITH THE POSSIBILITY OF A QUARTER-INCH WASHER BECOMING DISLODGED FROM THE EZ BREATHE ATOMIZER. THE IMPACTED ATOMIZER SERIAL NUMBER RANGES ARE: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
344925 EZ BREATHE ATOMIZER ATOMIZER CCQ HEALTH & LIFE (SUZHOU) CO., LTD. EZ-100 120701

Patients

Seq Age Sex Outcome Treatment
1 67 YR Other ASTHMANEFRIN INHALATION SOLUTION