FDA Adverse Event Malfunction Summary report: N

PERFECTO2 OXYGEN CONCENTRATOR WITH SENSO2 9153646963

MDR report key: 4501490 · Received February 10, 2015

Report

Report Number
1031452-2015-06660
Event Type
Malfunction
Date Received
February 10, 2015
Report Date
February 3, 2015
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

Additional Manufacturer Narrative · 1

INITIAL MFG REPORT # 1031452-2015-06660 WAS SUBMITTED TO THE FDA ON 02/10/2015. (B)(4).

Description of Event or Problem · 1

DEALER REPORTED THAT THE PILOT VALVES WERE REPLACED WHEN THE IRC5PO2V CONCENTRATOR DISPLAYED 1 RED AND 2 GREEN INDICATOR LIGHTS AND SHUT DOWN. DEALER STATED THAT THE SIEVE BEDS WERE "BLOWN" WITH WHITE DUST FILLING THE LOWER TUBES. DEALER ALSO STATED THAT THE POWER SWITCH FAILED TO ENABLE ALARM HORNS. THE DEALER STATED SIEVE BEDS WERE "BLOWN" WITH DUST FILLING LOWER TUBES. THE DEALER STATED POWER SWITCHES FAILED TO ENABLE ALARM HORNS.

Description of Event or Problem · 1

DEALER IS SWAPPING OUT ALL PILOT VALVES WITH NEW PART # 2003052 UNDER WARRANTY ALONG WITH O'RINGS. DEALER ALLEGES UNITS WHERE SHUTTING DOWN WITH TWO GREEN AND ONE RED ERROR CODE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
93737 PERFECTO2 OXYGEN CONCENTRATOR WITH SENSO2 9153646963 GENERATOR, OXYGEN, PORTABLE CAW INVACARE FLORIDA OPERATIONS IRC5PO2V

Patients

Seq Age Sex Outcome Treatment
1 Other