FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 4041067 · Received August 27, 2014

Report

Report Number
1031452-2014-07436
Event Type
Malfunction
Date Received
August 27, 2014
Date of Event
August 4, 2014
Report Date
August 4, 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

IT WAS REPORTED BY THE INDEPENDENT REPAIR CENTER THAT THE UNIT'S VALVE IS NOT SHIFTING, AND UNIT IS ALARMING. NO ALLEGATION OF PATIENT INJURY, NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
520329 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

Patients

Seq Age Sex Outcome Treatment
1 Other