FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 4211221 · Received October 29, 2014

Report

Report Number
1031452-2014-16493
Event Type
Malfunction
Date Received
October 29, 2014
Report Date
October 8, 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

INDEPENDENT REPAIR CENTER CUSTOMER ALLEGED UNIT HAS LOW O2 OR YELLOW LIGHT. NOTED IN THE REPAIR DOC THERE WAS LOOSE CABLE TIES TIGHTENED, AND REPAIRED LEAKS ON THE PE VALVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
692388 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

Patients

Seq Age Sex Outcome Treatment
1 Other