HYDRO-PULSE SINUS IRRIGATION SYSTEM CURRENT MODEL *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2007-02-01 for HYDRO-PULSE SINUS IRRIGATION SYSTEM CURRENT MODEL * manufactured by Hydro-med, Inc.

Event Text Entries

[578386] This is a copy of the letter i sent to the device mfr: since 06/05, i have owned three hydro-pulse sinus irrigation systems. The first one which i purchased upon the recommendation of dr of the school of medicine began leaking within six months of use, and shorted-out shortly thereafter. You replaced that one, with the unit that is the subject of this letter. I have a third device which is not used often. The replacement device was put into service in 06/06. It began leaking, exactly as the first one did, in 11/06. Last week, after returning from a week of travel, the device would not turn on. I left it plugged in, and within a hour smelled the distinctive order of burning electrical insulation. I discovered that the unit was hot to touch, and beginning to smoke. I unplugged it and removed it from my home. I estimate that this unit was used less than 300 times. At this point, i will not use the hydro-pulse device as i deem it an unacceptable shock and fire hazard. I am writing to inform you of this serious problem. As noted i have copied dr, as he should be apprised of this, also. Further, while i believe this device is regulated by the u. S. Consumer product safety commision, it could actually be under the jurisdiction of the u. S. Food and drug administration, as a medical device. Thus, i have copied this letter to both of those agencies. I look forward to your prompt attention to this and hope the problem is resolved before anyone is injured.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW1041838
MDR Report Key813346
Date Received2007-02-01
Date of Report2007-02-01
Date of Event2007-01-06
Date Added to Maude2007-02-08
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 Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameHYDRO-PULSE SINUS IRRIGATION SYSTEM
Generic NameNA
Product CodeKAR
Date Received2007-02-01
Model NumberCURRENT MODEL
Catalog Number*
Lot Number*
ID Number*
OperatorLAY USER/PATIENT
Device AvailabilityY
Device Age*
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key800833
ManufacturerHYDRO-MED, INC
Manufacturer Address4419 VAN NUYS BLVD SHERMAN OAKS CA 91403 US


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2007-02-01

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