FDA Adverse Event Malfunction Summary report: N

INOVO

MDR report key: 16460357 · Received March 1, 2023

Report

Report Number
1062191-2022-00001
Event Type
Malfunction
Date Received
March 1, 2023
Date of Event
September 9, 2022
Report Date
March 1, 2023
Manufacturer
INOVO, INC
Product Code
NFB
UDI-DI
00822383018515
PMA / PMN Number
K103392
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Description of Event or Problem · 0

INOVO INC. WAS NOTIFIED OF AN INCIDENT INVOLVING AN OXYGEN CONSERVER BY A PROVIDER WHO STATED THAT "A PATIENT HAD FITTED THE CONSERVER ONTO A CH MEDICAL OXYGEN CYLINDER BUT DID NOT TURN IT ON. APPROXIMATELY 24 HOURS LATER, THE PATIENT NEEDED TO VISIT THE GP AND WHEN OUTSIDE THE GP'S CLINIC THEY TURNED IT ON. AT THAT POINT THE PATIENT HEARD A HISSING NOISE AND THEN A BANG." THERE WAS NO REPORT OR EVIDENCE OF ILLNESS, INJURY OR MEDICAL TREATMENT ASSOCIATED WITH THE COMPLAINT. INOVO EVALUATED THE PRODUCT, WHICH REVEALED THAT THE IGNITION MECHANISM WAS FLOW FRICTION, WHICH CAN OCCUR IF THE SEAL WASHER WEARS OVER TIME, OR IF THE DEVICE IS NOT CONNECTED TO THE COMPRESSED OXYGEN CYLINDER TIGHTLY ENOUGH, BOTH OF WHICH ARE ADDRESSED BY THE DEVICE'S INSTRUCTIONS FOR USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
921345 INOVO CONSERVER, OXYGEN NFB INOVO, INC OM-900A 00822383018515

Patients

Seq Age Sex Outcome Treatment
1 Unknown