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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SUNBEAM PRODUCTS, INC., DBA JARDEN CONSUMER SOLUTI SUNBEAM; HUMIDIFIER
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SUNBEAM PRODUCTS, INC., DBA JARDEN CONSUMER SOLUTI SUNBEAM; HUMIDIFIER Back to Search Results
Device Problem Fire (1245)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 02/14/2017
Event Type  malfunction  
Manufacturer Narrative
Consumer has not returned the product.
 
Event Description
An insurance company is making a subrogation claim and alleging that a humidifier was the cause of a fire that damaged its insured's property.There was not a report of personal injury with this incident.
 
Event Description
An insurance company is making a subrogation claim and alleging that a humidifier was the cause of a fire that damaged its insured's property.There was not a report of personal injury with this incident.
 
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Brand Name
SUNBEAM
Type of Device
HUMIDIFIER
Manufacturer (Section D)
SUNBEAM PRODUCTS, INC., DBA JARDEN CONSUMER SOLUTI
2381 executive center dr.
boca raton FL 33431
Manufacturer (Section G)
DONGGUAN HUIXAN ELECTRICAL PRODUCTS CO.
no. 9112, hung yeh 8th road
tangxia town,
CH  
Manufacturer Contact
michael miles
303 nelson ave.
neosho, MO 64850
4174557441
MDR Report Key6643459
MDR Text Key77786887
Report Number3003862163-2017-00130
Device Sequence Number1
Product Code KFZ
Combination Product (y/n)N
Reporter Country CodeCA
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type other
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 11/30/2017
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Initial Date Manufacturer Received Not provided
Initial Date FDA Received06/15/2017
Supplement Dates Manufacturer ReceivedNot provided
Supplement Dates FDA Received11/30/2017
Was Device Evaluated by Manufacturer? Yes
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
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