FDA Adverse Event Other Summary report: N

EVERGO OXYGEN CONCENTRATOR

MDR report key: 2845036 · Received November 8, 2012

Report

Report Number
1040777-2012-00025
Event Type
Other
Date Received
November 8, 2012
Date of Event
October 15, 2012
Report Date
October 15, 2012
Manufacturer
RESPIRONICS INC.
Product Code
CAW
PMA / PMN Number
K043615
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFORMATION ALLEGING AN EVERGO OXYGEN CONCENTRATOR'S DC ADAPTOR WAS HOT TO THE TOUCH AND BURNED A PATIENT'S FINGER. THE PATIENT WAS USING THE DC ADAPTOR IN A CAR WHEN THEY UNPLUGGED THE ADAPTOR FROM THE CAR DC OUTLET, THEY ALLEGEDLY RECEIVED A BURN. THE BURN REPORTEDLY BECAME INFECTED AND THE PATIENT REQUIRED ANTIBIOTICS TO TREAT THE INFECTION. THE DEVICE HAS YET TO BE RETURNED FOR AN EVALUATION BY THE MANUFACTURER. A FOLLOW UP REPORT WILL BE FILED WHEN THE INVESTIGATION IS COMPLETE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EVERGO OXYGEN CONCENTRATOR GENERATOR, OXYGEN, PORTABLE CAW RESPIRONICS INC. 900-000-02

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention