FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 2923571 · Received January 22, 2013

Report

Report Number
1031452-2013-00125
Event Type
Malfunction
Date Received
January 22, 2013
Report Date
January 19, 2013
Manufacturer
INVACARE FLORIDA OPERATIONS
Product Code
CAW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

MDR DECISION DATE: (B)(6). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. PROVIDER STATES ALARM WILL NOT SOUND. MDR FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
31352 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5LX02

Patients

Seq Age Sex Outcome Treatment
1 Other