FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 4121772 · Received September 26, 2014

Report

Report Number
1031452-2014-11173
Event Type
Malfunction
Date Received
September 26, 2014
Report Date
September 5, 2014
Manufacturer
INVACARE FLORIDA OPERATIONS
Product Code
CAW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
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 REGULATOR TO THE PRODUCT TANK WAS LEAKING. AN ADDITIONAL MALFUNCTION WAS THE CONTROL PANEL WAS BROKEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
601380 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5P

Patients

Seq Age Sex Outcome Treatment
1 Other