FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 3973694 · Received August 1, 2014

Report

Report Number
1031452-2014-05103
Event Type
Malfunction
Date Received
August 1, 2014
Date of Event
June 27, 2014
Report Date
June 27, 2014
Manufacturer
INVACARE FLORIDA OPERATIONS
Product Code
CAW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PROVIDER ALLEGED UNIT ALARMING. NO ADDITIONAL INFORMATION PROVIDED, NO INJURY ALLEGED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
450037 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

Patients

Seq Age Sex Outcome Treatment
1 Other