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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: KAZ USA, INC., A HELEN OF TROY COMPANY CVS HEALTH; STEAM INHALER

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KAZ USA, INC., A HELEN OF TROY COMPANY CVS HEALTH; STEAM INHALER Back to Search Results
Model Number GIH120
Device Problem Fluid/Blood Leak (1250)
Patient Problem Partial thickness (Second Degree) Burn (2694)
Event Type  Injury  
Manufacturer Narrative
Kaz usa, inc.Has requested that the product be returned to our company for testing, but it has not yet been received.
 
Event Description
A consumer reported that she received second degree burns on her thigh from hot water that spilled out of the personal steam inhaler.It is unknown whether medical intervention was sought for their injuries.Incidents of this nature are most likely to occur if the unit is being moved or lifted during use.The instructions for proper use have a clear warning that states "the appliance should always be placed on a firm, flat waterproof surface", "caution: do not place on lap or lift in your hands while in operation and if the unit still contains water", and "never move the appliance while in use.It can spill hot water if tilted or tipped over causing injury or burns".Kaz usa, inc.Has requested that the product be returned to our company for testing.
 
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Brand Name
CVS HEALTH
Type of Device
STEAM INHALER
Manufacturer (Section D)
KAZ USA, INC., A HELEN OF TROY COMPANY
400 donald lynch boulevard
marlborough, ma
Manufacturer Contact
sonja wilkinson
400 donald lynch boulevard
suite 300
marlborough, ma 
4907236
MDR Report Key9831407
MDR Text Key183374121
Report Number1314800-2020-00014
Device Sequence Number1
Product Code KFZ
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date 03/13/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Lay User/Patient
Device Model NumberGIH120
Device Lot Number23519MGH
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 02/26/2020
Initial Date FDA Received03/13/2020
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured08/23/2019
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
Patient Outcome(s) Other;
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