FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 3974809 · Received August 4, 2014

Report

Report Number
1031452-2014-05148
Event Type
Malfunction
Date Received
August 4, 2014
Report Date
June 27, 2014
Manufacturer
INVACARE FLORIDA OPERATIONS
Product Code
CAW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER PROVIDER MANIFOLD VALVE IS NOT SHIFTING FULLY. PER REPAIR STATEMENT UNIT IS ALARMING AND SHOWING A RED LIGHT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
453424 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

Patients

Seq Age Sex Outcome Treatment
1 Other