BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL)

    MDR report key: 4240652 · Received November 10, 2014

    Report

    Report Number
    1031452-2014-18189
    Event Type
    Malfunction
    Date Received
    November 10, 2014
    Report Date
    October 22, 2014
    Manufacturer
    INVACARE FLORIDA OPERATIONS
    Product Code
    CAW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AR, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE DEALER STATES THAT WHEN THE DEVICE RUNS FOR A MINUTE THE RED LIGHT GOES OFF AND THE DEVICE STARTS THE ALARMING/SIREN NOISE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    724054 PORTABLE OXYGEN GENERATOR (CONCENTRATOR, HOMEFILL) 868.5440 CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

    Patients

    Seq Age Sex Outcome Treatment
    1 Other