BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

    MDR report key: 4201885 · Received October 27, 2014

    Report

    Report Number
    9616091-2014-02254
    Event Type
    Malfunction
    Date Received
    October 27, 2014
    Report Date
    October 2, 2014
    Manufacturer
    INVAMEX
    Product Code
    CAW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES CDL DRIVE COMPLETELY FELL APART.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    682902 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVAMEX 9SL

    Patients

    Seq Age Sex Outcome Treatment
    1 Other