Brand Name | SUNBEAM |
Type of Device | HUMIDIFIER |
Manufacturer (Section D) |
SUNBEAM PRODUCTS, INC., DBA JARDEN CONSUMER SOLUTIONS |
2381 executive ctr dr |
boca raton FL |
|
Manufacturer (Section G) |
DONGGUAN HUIXAN ELECTRICAL PRODUCTS CO |
no.9112,hung yeh 8th road |
|
tangxia town,dongguan |
CH
|
|
Manufacturer Contact |
tracie
jones
|
po box 2931 |
wichita, KS 67201
|
3162197325
|
|
MDR Report Key | 3856230 |
MDR Text Key | 19590423 |
Report Number | 3003862163-2014-00069 |
Device Sequence Number | 1 |
Product Code |
KFZ
|
Combination Product (y/n) | N |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Consumer |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
04/11/2014 |
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
|
Device Model Number | SUL496 |
Was Device Available for Evaluation? |
No
|
Initial Date Manufacturer Received |
Not provided
|
Initial Date FDA Received | 04/11/2014 |
Was Device Evaluated by Manufacturer? |
No
|
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |
|
|