Brand Name | WALGREENS |
Type of Device | HEATING PAD |
Manufacturer (Section D) |
SUNBEAM PRODUCTS, INC., DBA JARDEN CONSUMER SOLUTI |
2381 executive center dr. |
boca raton FL 33431 |
|
Manufacturer (Section G) |
SKY EAGLE HOLDINGS CORP. |
no. 128, chung hwa rd., sec. 2 |
|
taipei hsien, 236 |
TW
236
|
|
Manufacturer Contact |
michael
miles
|
303 nelson ave. |
neosho, MO 64850
|
4174557441
|
|
MDR Report Key | 6767116 |
MDR Text Key | 81819409 |
Report Number | 3007790958-2017-00141 |
Device Sequence Number | 1 |
Product Code |
IRT
|
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
other |
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup |
Report Date |
01/22/2018 |
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 |
Other
|
Device Model Number | 2022 |
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 Received | 08/04/2017 |
Supplement Dates Manufacturer Received | Not provided
|
Supplement Dates FDA Received | 01/23/2018
|
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 05/06/2016 |
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 |
Patient Outcome(s) |
Other;
|
|
|