MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-04-05 for KBL TOWER PURE ENERGY TOWER (2005) manufactured by Kbl Ag.
[72068826]
Claimant alleges sunbed caught fire.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3006116732-2017-00003 |
| MDR Report Key | 6459746 |
| Date Received | 2017-04-05 |
| Date of Report | 2017-03-29 |
| Date of Event | 2017-01-16 |
| Date Mfgr Received | 2017-02-09 |
| Device Manufacturer Date | 2006-11-01 |
| Date Added to Maude | 2017-04-05 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MR. THOMAS LAHR |
| Manufacturer Street | RINGSTRASSE 24-26 |
| Manufacturer City | DERNBACH, 56307 |
| Manufacturer Country | GM |
| Manufacturer Postal | 56307 |
| Manufacturer Phone | 4926899426 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | KBL TOWER PURE ENERGY |
| Generic Name | SUNLAMP PRODUCT |
| Product Code | LEJ |
| Date Received | 2017-04-05 |
| Model Number | TOWER PURE ENERGY |
| Catalog Number | TOWER (2005) |
| Device Availability | Y |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 0 |
| Device Event Key | 0 |
| Manufacturer | KBL AG |
| Manufacturer Address | RINGSTRASSE 24-26 DERNBACH, RLP 56307 GM 56307 |
| Brand Name | KBL TOWER PURE ENERGY |
| Generic Name | SUNLAMP PRODUCT |
| Product Code | LEJ |
| Date Received | 2017-04-05 |
| Model Number | TOWER PURE ENERGY |
| Catalog Number | TOWER (2005) |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | KBL AG |
| Manufacturer Address | RINGSTRASSE 24-26 DERNBACH, RLP 56307 GM 56307 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-04-05 |