LIPSHAW 225 *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2010-02-19 for LIPSHAW 225 * manufactured by Lipshaw.

Event Text Entries

[1322111] Fire in paraffin pot. When the tech lifted the lid of the paraffin pot, flames shot up quickly to the ceiling. The paraffin dispenser is a lipshaw model # 225, (b) (4). This particular model is not equipped with an overtemp or safety shutoff feature. The device had a thermostat replaced in (b) (6) 2003 and again in (b) (6) 2009.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5014869
MDR Report Key1614799
Date Received2010-02-19
Date of Report2010-02-19
Date of Event2010-02-14
Date Added to Maude2010-02-25
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameLIPSHAW
Generic NamePARAFFIN POT
Product CodeIMC
Date Received2010-02-19
Model Number225
Catalog Number*
Lot Number*
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Sequence No1
Device Event Key0
ManufacturerLIPSHAW
Manufacturer Address* * *


Patients

Patient NumberTreatmentOutcomeDate
10 2010-02-19

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