FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 4192044 · Received October 22, 2014

Report

Report Number
1031452-2014-15450
Event Type
Malfunction
Date Received
October 22, 2014
Report Date
October 2, 2014
Manufacturer
INVACARE FLORIDA OPERATIONS
Product Code
CAW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, 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 PURITY CHAMBER HOSE WAS LOOSE FROM REGULATOR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
671377 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2

Patients

Seq Age Sex Outcome Treatment
1 Other