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U.S. Department of Health and Human Services

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

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KAZ USA, INC., A HELEN OF TROY COMPANY VICKS; PERSONAL STEAM INHALER Back to Search Results
Model Number VIH200
Medical Device Problem Codes Use of Device Problem (1670); Device Handling Problem (3265); Patient Device Interaction Problem (4001)
Health Effect - Clinical Code Full thickness (Third Degree) Burn (2696)
Date of Event 07/02/2023
Type of Reportable Event Serious Injury
Event or Problem Description
A consumer reported that she received third degree burns on her thigh from hot water that spilled from the personal steam inhaler.She stated that she attempted to open the unit during use and hot water spilled out of the unit, resulting in her injuries.Medical intervention was sought for her injuries, as well as multiple follow up visits.The instructions for proper use have clear warnings that state "caution: never move the appliance while in use.It can spill hot water if tilted, shaken or tipped over causing injury or burns", as well as "allow the appliance to cool for at least 20 minutes before moving or refilling it".Kaz usa, inc.Has requested that the product be returned to our company for testing.
 
Additional Manufacturer Narrative
Kaz usa, inc.Has requested that the product be returned to our company for testing, but it has not yet been received.
 
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Brand Name
VICKS
Common Device Name
PERSONAL STEAM INHALER
Manufacturer (Section D)
KAZ USA, INC., A HELEN OF TROY COMPANY
marlborough MA 01752
Manufacturer Contact
sonja wilkinson
400 donald lynch boulevard
suite 300
marlborough, MA 01752
5084907236
MDR Report Key17498301
Report Number1314800-2023-00010
Device Sequence Number12360321
Product Code KFZ
UDI-Device Identifier00328785502008
UDI-Public00328785502008
Combination Product (Y/N)N
Initial Reporter StateNY
Initial Reporter CountryUS
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 08/10/2023
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
Operator of Device Lay User/Patient
Device Model NumberVIH200
Device Lot Number18421
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/12/2023
Initial Report FDA Received Date08/10/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured07/03/2021
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Outcome Attributed to Adverse Event Other; Required Intervention; Hospitalization;
Patient SexFemale
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