BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

    MDR report key: 3970959 · Received July 31, 2014

    Report

    Report Number
    1031452-2014-04713
    Event Type
    Malfunction
    Date Received
    July 31, 2014
    Report Date
    June 17, 2014
    Manufacturer
    INVACARE FLORIDA OPERATIONS
    Product Code
    CAW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    DURING TESTING AT THE SERVICE CENTER, THE DEVICE DISPLAYED A RED LIGHT VISUAL ALARM. THIS WAS DUE TO THE FOUR WAY VALVE BEING STUCK.

    Description of Event or Problem · 1

    DURING TESTING AT THE SERVICE CENTER THE DEVICE DISPLAYED A RED LIGHT VISUAL ALARM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    447652 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5P

    Patients

    Seq Age Sex Outcome Treatment
    1 Other