FDA Adverse Event Malfunction Summary report: N

PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

MDR report key: 4211387 · Received October 29, 2014

Report

Report Number
1031452-2014-16592
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
TX, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER INDEPENDENT REPAIR CENTER STATEMENT ALLEGED ALARMING THE KEY FAILURE IS THE PILOT VALVE IS NOT WORKING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
693012 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

Patients

Seq Age Sex Outcome Treatment
1 Other