FDA Adverse Event Malfunction Summary report: N

EZ BREATHE ATOMIZER

MDR report key: 3522517 · Received November 20, 2013

Report

Report Number
1054871-2013-00096
Event Type
Malfunction
Date Received
November 20, 2013
Date of Event
October 28, 2013
Report Date
November 20, 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 PT CONTACTED NEPHRON PHARMACEUTICALS CORPORATION ON (B)(6) 2013, REGARDING A REPORTABLE PRODUCT COMPLAINT OF NO AEROSOL PRODUCTION ASSOCIATED WITH THE EZ BREATHE ATOMIZER FAILED TO PRODUCE AN AEROSOL MIST DESPITE CLEANING THE UNIT ACCORDING TO THE PRODUCT'S INSTRUCTIONS. DURING A F/U PHONE CALL ON (B)(6) 2013, THE PT ADDED THAT HE EXPERIENCED AN ASTHMA ATTACK WHEN THE ATOMIZER FAILED TO PRODUCE AN AEROSOL MIST; HOWEVER, HE REPORTED THAT HE USED A FRIEND'S INHALER TO ALLEVIATE THE SYMPTOMS OF HIS ASTHMA EXACERBATION. THE PT IS A 46 YR OLD MALE WITH A PAST MEDICAL HISTORY THAT IS SIGNIFICANT FOR ASTHMA (ALL HIS LIFE). HE REPORTED THAT HE IS A FORMER SMOKER AND IS NOT AWARE OF ANY ALLERGIES TO MEDICATIONS. 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 BREATH ATOMIZER. THE IMPACTED ATOMIZER SERIAL NUMBER RANGES ARE: (B)(4). BASELINE RESPIRATORY STATUS, CONCOMITANT MEDICATIONS AND THE CLINICAL COURSE OF ASTHMA ATTACK WERE NOT PROVIDED. CAUSALITY IS CONSERVATIVELY ASSESSED AS POSSIBLE, DUE TO LACK OF ADMINISTRATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
602265 EZ BREATHE ATOMIZER ATOMIZER CCQ HEALTH & LIFE (SUZHOU) CO., LTD. EZ-100 120901

Patients

Seq Age Sex Outcome Treatment
1 46 YR Other