HOMEDICS PAR-120 UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00,04 report with the FDA on 2007-02-27 for HOMEDICS PAR-120 UNK manufactured by Kwonnie Electrical Products, Ltd..

Event Text Entries

[573519] A paraffin bath product may have been involved in the cause or spread of a house fire.
Patient Sequence No: 1, Text Type: D, B5


[7942699] The inspection of the product disclosed no defect in the spa or any basis for making a claim against homedics. 6/3/2004: the fire investigation revealed a halogen lamp as the most likely cause of the fire.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1832894-2006-00006
MDR Report Key827473
Report Source00,04
Date Received2007-02-27
Date of Report2006-12-08
Date of Event2001-12-30
Date Facility Aware2002-05-20
Report Date2006-12-22
Date Mfgr Received2002-05-20
Date Added to Maude2007-03-15
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactDAVE VANDERLIN
Manufacturer Street3000 PONTIAC TRAIL
Manufacturer CityCOMMERCE TWP. MI 48390
Manufacturer CountryUS
Manufacturer Postal48390
Manufacturer Phone2488633000
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Remedial ActionNO
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameHOMEDICS
Generic NamePARAFFIN BATH
Product CodeIMC
Date Received2007-02-27
Model NumberPAR-120
Catalog NumberUNK
Lot NumberUNK
ID Number*
OperatorLAY USER/PATIENT
Device AvailabilityY
Device AgeUNKNOWN
Device Eval'ed by MfgrY
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key814870
ManufacturerKWONNIE ELECTRICAL PRODUCTS, LTD.
Manufacturer Address* KOWLOON HK
Baseline Brand NameHOMEDICS
Baseline Generic NamePARAFFIN BATH
Baseline Model NoPAR-120
Baseline Catalog NoUNK
Baseline ID*


Patients

Patient NumberTreatmentOutcomeDate
101. Death 2007-02-27

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