The National Patient Safety Team were made aware through the Medical Device Safety Officer network of concerns relating to Biozoon, a product used to enhance taste in those with limited or no ability to swallow safely. Concerns related to overheating if the battery was inserted incorrectly and the potential risk of infection between uses.

A review of incident data revealed similar reported issues. Since the product is not a medical device, it was determined that direct contact with the manufacturer was appropriate. The manufacturer had already begun making changes to product information based on user feedback and, through positive engagement, they agreed to issue a statement to those who had already purchased the product outlining the new resources. This positive engagement with the manufacturer and their subsequent changes to the website and product information, plus plans for a new improved device design, are positive changes to support safe use of a product which enhances quality of life for a niche group of patients often in the end stages of life.