FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 4180433 · Received October 17, 2014

Report

Report Number
1031452-2014-14712
Event Type
Malfunction
Date Received
October 17, 2014
Report Date
September 30, 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 INDEPENDENT REPAIR CENTER STATEMENT, ALARMING/RED LIGHT, KEY FAILURE, PILOT VALVE, DEFECTIVE TIE WRAP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
662822 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

Patients

Seq Age Sex Outcome Treatment
1 Other