BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

    MDR report key: 4191614 · Received October 22, 2014

    Report

    Report Number
    1031452-2014-15424
    Event Type
    Malfunction
    Date Received
    October 22, 2014
    Report Date
    October 1, 2014
    Manufacturer
    INVACARE FLORIDA OPERATIONS
    Product Code
    CAW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES, THE DC CHARGER PLUG IS PARTIALLY MELTED. HE STATES, THE END USER SMELLED A BURNING SMELL AND IMMEDIATELY DISCONNECTED THE DC PLUG. NO INJURIES. DEALER STATES, THE FUSE WAS NOT IN THE END PLUG BUT WAS NOT AWARE IF THE END USER HAD TAMPERED WITH IT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    673105 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS XPO100B

    Patients

    Seq Age Sex Outcome Treatment
    1 Other