MAUDE Adverse Event Report: KAZ USA VICKS WARM MOISTURE HUMIDIFIER; HEATING, VENTILATION & AIR CONDITIONING

Device Problems Fire (1245); Melted (1385); Smoking (1585); Noise, Audible (3273)

Patient Problem No Known Impact Or Consequence To Patient (2692)

Event Date 10/02/2017

Event Type  malfunction  

Event Description

Last night we had filled up our vicks warm moisture humidifier.We went to bed around 8pm.Shortly after midnight we were awoken to the smoke alarm going off.There was a slight haze of smoke and smell of something burning.We quickly noticed that there was smoke coming from the humidifier.I unplugged it and my wife dumped her glass of water on it.It made a bunch of popping noises, but the smoke stopped.We let it cool and then took it apart to find that part of the plastic had melted and caught fire.Incident location: (b)(6), united states, this is my home address.Document number: (b)(4).Report number: (b)(4).Vicks warm moisture humidifier purchased from (b)(6).Retailer: (b)(6).

• Brand Name: VICKS WARM MOISTURE HUMIDIFIER
• Type of Device: HEATING, VENTILATION & AIR CONDITIONING
• Manufacturer (Section D): KAZ USA
• MDR Report Key: 6957980
• MDR Text Key: 89602155
• Report Number: MW5072806
• Device Sequence Number: 1
• Product Code: KFZ
• Combination Product (y/n): N
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Patient
• Type of Report: Initial
• Report Date: 10/03/2017

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: No Information
• Was Device Available for Evaluation?: Yes
• Initial Date Manufacturer Received: Not provided
• Initial Date FDA Received: 10/18/2017
• Was Device Evaluated by Manufacturer?: No Information
• Type of Device Usage: N
• Patient Sequence Number: 1
• Patient Age: 47 YR