MAUDE Adverse Event Report: PHILIPS-RESPIRONICS INC. OXYGEN CONCENTRATOR; GENERATOR, OXYGEN, PORTABLE

Model Number EVERFLO

Device Problem Fire (1245)

Patient Problem Full thickness (Third Degree) Burn (2696)

Event Date 01/15/2013

Event Type  Injury  

Event Description

Patient was smoking a caught b/u on fire.She had to be sent to the hospital for 3rd degree burns to her face.She at first said it was the cord that caught on file.But after further speaking to her she admitted that she had been smoking.This report reflects information received by fda in the form of a notification per 803.22 (b)(2).

• Brand Name: OXYGEN CONCENTRATOR
• Type of Device: GENERATOR, OXYGEN, PORTABLE
• Manufacturer (Section D): PHILIPS-RESPIRONICS INC.
• MDR Report Key: 17516573
• MDR Text Key: 321037477
• Report Number: MW5123522
• Device Sequence Number: 1
• Product Code: CAW
• Combination Product (y/n): N
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 02/06/2013

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 08/11/2023
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: No
• Device Model Number: EVERFLO
• Patient Sequence Number: 1
• Patient Age: 70 YR