FDA Adverse Event Injury Summary report: N

EZ BREATHE ATOMIZER

MDR report key: 3462458 · Received August 29, 2013

Report

Report Number
1054871-2013-00069
Event Type
Injury
Date Received
August 29, 2013
Date of Event
August 2, 2013
Report Date
August 29, 2013
Manufacturer
HEALTH & LIFE (SUZHOU) CO., LTD.
Product Code
CCQ
Product Problem
Yes
Report Source
Distributor report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

THE CUSTOMER'S SPOUSE SPOUSE CONTACTED NEPHRON PHARMACEUTICALS CORPORATION REGARDING A PRODUCT COMPLAINT ASSOCIATED WITH THE EZ BREATHE ATOMIZER ON (B)(6) 2013. THE INITIAL REPORTER STATED THAT THE ATOMIZER FAILED TO PRODUCE AN AEROSOL MIST WHILE HER HUSBAND WAS EXPERIENCING AN ASTHMA ATTACK. HER HUSBAND WENT TO THE EMERGENCY DEPARTMENT AT THE HOSPITAL AND REQUIRED NEBULIZER TREATMENTS TO ALLEVIATE HIS ASTHMA SYMPTOMS. THE PT IS A (B)(6) Y/O MALE WITH A PAST MEDICAL HISTORY THAT IS SIGNIFICANT FOR ASTHMA. HE IS A NONSMOKER AND REPORTS ALLERGIES TO PENICILLIN. THE INVESTIGATED PRODUCT FOR THE ENCLOSED MEDICAL DEVICE REPORT IS LISTED AMONG THE IMPLICATED LOTS FOR A NATIONWIDE RECALL INITIATED BY THE MFR HEALTH & LIFE CO., LTD., ON MAY 8, 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
425717 EZ BREATHE ATOMIZER ATOMIZER CCQ HEALTH & LIFE (SUZHOU) CO., LTD. EZ-100 120701

Patients

Seq Age Sex Outcome Treatment
1 18 YR Hospitalization| O