FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 4039930 · Received August 27, 2014

Report

Report Number
1031452-2014-07472
Event Type
Malfunction
Date Received
August 27, 2014
Report Date
August 4, 2014
Manufacturer
INVACARE FLORIDA OPERATIONS
Product Code
CAW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER INDEPENDENT REPAIR CENTER STATEMENT, THE UNIT HAD LOW O2 OR YELLOW LIGHT. THE KEY FAILURE WAS THE SIEVE BEDS BEING DEFECTIVE. ADDITIONAL MALFUNCTIONS WERE 2 MD HOSE CLAMPS WERE INSTALLED, ON/OFF SWITCH HAD NO ALARM AND 8 TIE WRAPS WERE INSTALLED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
522207 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

Patients

Seq Age Sex Outcome Treatment
1 Other