FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 3950411 · Received July 22, 2014

Report

Report Number
1031452-2014-04189
Event Type
Malfunction
Date Received
July 22, 2014
Report Date
June 17, 2014
Manufacturer
INVACARE FLORIDA OPERATIONS
Product Code
CAW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

(B)(4). DEALER STATED THE MOTOR IS CEASED ON THE UNIT. DEALER STATED THE UNIT IS A RENTAL UNIT, NO END USER INVOLVEMENT

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
427904 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

Patients

Seq Age Sex Outcome Treatment
1 Other