FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 2940238 · Received February 2, 2013

Report

Report Number
1031452-2013-00201
Event Type
Malfunction
Date Received
February 2, 2013
Report Date
January 31, 2013
Manufacturer
INVACARE FLORIDA OPERATIONS
Product Code
CAW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). NO RMA HAS BEEN INITIATED FOR THIS ISSUE. THE MALFUNCTION HAS NOT BEEN CONFIRMED.

Description of Event or Problem · 1

PER DEALER UNIT IS SHUTTING DOWN AND STARTING ON IT'S OWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
45437 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2

Patients

Seq Age Sex Outcome Treatment
1 Other