BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ALBERTSON'S DELUXE WATER BOTTLE

    MDR report key: 515025 · Received March 5, 2004

    Report

    Report Number
    1520456-2004-00001
    Event Type
    Injury
    Date Received
    March 5, 2004
    Date of Event
    August 26, 2003
    Report Date
    February 12, 2004
    Manufacturer
    ABBOTT LABORATORIES
    Product Code
    FPF
    Removal / Correction Number
    UNK
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    REPORT RECEIVED OF A WATER BOTTLE THAT "BROKE' CAUSING BURNS. REPORTEDLY, IN 2003 THE PT FILLED THE HOT WATER BOTTLE FROM THE TAP AND PLACED IT ON THEIR LEFT KNEE "OVER MY PAJAMAS." AT AN UNSPECIFIED TIME DURING USE, REPORTEDLY THE HOT WATER BOTTLE BROKE AT AN UNSPECIFIED AREA AND HOT WATER "STARTED TO LEAK DOWN MY LEG. I THOUGHT THE CAP HAD COME OFF, BUT WHEN THE PARAMEDICS CAME, THEY SAID IT WAS STILL ON." THE PT REPORTEDLY WAS TAKEN BY AMBULANCE TO THE HOSP AND WAS REFERRED TO THEIR PHYSICIAN FOR FURTHER EVALUATION AND TREATMENT. THE PT REQUIRED DRESSING CHANGES EVERY OTHER DAY BY A VISITING RN AND UNSPECIFIED DOSES OF VICODIN FOR PAIN. THOUGH REQUESTED, NO ADDITIONAL INFO WAS PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ALBERTSON'S DELUXE WATER BOTTLE HOT WATER BOTTLE FPF ABBOTT LABORATORIES NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Required Intervention