FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 4151256 · Received October 8, 2014

Report

Report Number
3008262382-2014-01479
Event Type
Malfunction
Date Received
October 8, 2014
Report Date
September 16, 2014
Manufacturer
INVACARE REHABILITATION EQUIP
Product Code
CAW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER INDEPENDENT REPAIR CENTER STATEMENT THE UNIT WAS ALARMING OR RED LIGHT. THE KEY FAILURE WAS THE 4 WAY VALVE NOT SHIFTING. ADDITIONAL MALFUNCTIONS INCLUDE THE LED PANEL WAS DAMAGED, AND THE HOSE CLAMPS WERE LEAKING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
632544 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE REHABILITATION EQUIP IRC5P

Patients

Seq Age Sex Outcome Treatment
1 Other