PERSONAL STEAM INHALER ZL101

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-10-01 for PERSONAL STEAM INHALER ZL101 manufactured by Walgreens / Kaz Usa Inc., A Helen Of Troy Company.

Event Text Entries

[122660947] On the morning of (b)(6) 2018, i plugged in (b)(6) personal steam inhaler, and after about 10 minutes using the inhaler to clear my sinus congestion, it popped in my face. The device didn? T break, but it popped like an explosion and i threw it away from my face. The steam and liquid splashed on my face. My face was burning, turned red and was getting swollen. So i went to (b)(6) emergency room in (b)(6). I was treated and released with 1st degree and 2nd degree burns. I don? T know why this device, item number #a53e0097, model #zl101, wic #(b)(4), svc code: (b)(4) popped and burned my face. I? M scheduled to see the (b)(6) clinic at (b)(6) on (b)(6) 2018.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5080252
MDR Report Key7926030
Date Received2018-10-01
Date of Report2018-09-28
Date of Event2018-09-25
Date Added to Maude2018-10-02
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NamePERSONAL STEAM INHALER
Generic NameHUMIDIFIER / NON INOVASIVE PATIENT INTERFACE
Product CodeKFZ
Date Received2018-10-01
Model NumberZL101
OperatorLAY USER/PATIENT
Device AvailabilityY
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerWALGREENS / KAZ USA INC., A HELEN OF TROY COMPANY


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-10-01

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