BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VICKS

    MDR report key: 451726 · Received March 31, 2003

    Report

    Report Number
    1314800-2003-00004
    Event Type
    Malfunction
    Date Received
    March 31, 2003
    Date of Event
    March 20, 2003
    Report Date
    March 28, 2003
    Manufacturer
    KAZ, INC.
    Product Code
    KFZ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    CONSUMER CALLED TO REPORT THAT HUMIDIFIER WAS NOT ON. TURNED UNIT ON AND NOTHING HAPPENED. PICKED UNIT UP AND NOTICED HOLE IN BOTTOM OF UNIT AND UNIT STUCK TO CARPET.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VICKS WARM MIST HUMIDIFIER KFZ KAZ, INC. V610 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN