BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

    MDR report key: 3971044 · Received July 31, 2014

    Report

    Report Number
    1031452-2014-04982
    Event Type
    Malfunction
    Date Received
    July 31, 2014
    Report Date
    June 26, 2014
    Manufacturer
    INVACARE FLORIDA OPERATIONS
    Product Code
    CAW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    CUSTOMER FORWARDED A SPREADSHEET WITH MULTIPLE UNITS WITH VARIOUS ISSUES. SPECIFIC DETAILS TO THE SYMPTOM OF THE PRODUCT NOT AVAILABLE. THE ONLY NOTE WAS MADE BY THE TBM STATING THE UNITS ARE SHUTTING DOWN. SPREADSHEET ONLY DETAILS WHICH PART WAS REPLACED. ON THIS UNIT THEY STATE THEY HAVE REPLACED THE FOLLOWING COMPONENT- COMPRESSOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    448206 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

    Patients

    Seq Age Sex Outcome Treatment
    1 Other