FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 3932494 · Received July 14, 2014

Report

Report Number
1031452-2014-03480
Event Type
Malfunction
Date Received
July 14, 2014
Report Date
June 9, 2014
Manufacturer
INVACARE FLORIDA OPERATIONS
Product Code
CAW
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER PROVIDER, ERROR CODE 3 AND 4.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
410437 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS XPO100B

Patients

Seq Age Sex Outcome Treatment
1 Other