MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a other report with the FDA on 2020-02-27 for SUNBEAM SWM6000 manufactured by Sunbeam Products, Inc..
[184632569]
An insurance company is making a subrogation claim under case reference number (b)(4) and alleging that a humidifier was the cause of a fire that damaged its insured's property. There was not a report of personal injury with this incident.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3010341502-2020-00017 |
| MDR Report Key | 9763681 |
| Report Source | OTHER |
| Date Received | 2020-02-27 |
| Date of Report | 2020-02-27 |
| Date of Event | 2019-12-29 |
| Date Added to Maude | 2020-02-27 |
| 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 | MICHAEL MILES |
| Manufacturer Street | 303 NELSON AVE. |
| Manufacturer City | NEOSHO, MO |
| Manufacturer Country | US |
| Manufacturer Phone | 4557441 |
| Manufacturer G1 | CHUZHOU DONLIM ELECTRICAL APPLIANCES CO.,LTD. |
| Manufacturer Street | NO.1777 YANGZI EAST ROAD |
| Manufacturer City | CHUZHOU, ANHUI 239000 |
| Manufacturer Country | CH |
| Manufacturer Postal Code | 239000 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | SUNBEAM |
| Generic Name | HUMIDIFIER |
| Product Code | KFZ |
| Date Received | 2020-02-27 |
| Model Number | SWM6000 |
| Device Availability | N |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SUNBEAM PRODUCTS, INC. |
| Manufacturer Address | 2381 EXECUTIVE CENTER DR. BOCA RATON, FL US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-02-27 |