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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Respironics, Inc. EverFlo; Generator, Oxygen, Portable

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Respironics, Inc. EverFlo; Generator, Oxygen, Portable Back to Search Results
Model Number 1020001
Medical Device Problem Code Thermal Decomposition of Device (1071)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/04/2026
Type of Reportable Event Malfunction
Event or Problem Description
The manufacturer received information alleging that the device has a power cord damage, pca short and will not start up.The sieve leak is producing low 02, inlet is dirty, compressor plugs and manifold melted out.There was no report of serious or permanent harm or injury.There was no report of medical intervention.
 
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Brand Name
EverFlo
Common Device Name
Generator, Oxygen, Portable
Manufacturer (Section D)
Respironics, Inc.
1001 murry ridge lane
murrysville PA
Manufacturer (Section G)
Respironics, Inc.
1001 murry ridge lane
murrysville PA
Manufacturer Contact
melissa rosko
1001 murry ridge lane
murrysville, PA 
+1(724)733-0200
MDR Report Key50216603
Report Number2518422-2026-042987
Device Sequence Number20357962
Product Code CAW
UDI-Device Identifier00606959022041
UDI-Public(01)00606959022041
Combination Product (Y/N)N
Initial Reporter CountryCA
PMA/510(K) Number
K061261
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Consumer
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 08/11/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Lay User/Patient
Device Model Number1020001
Device Catalogue Number1020001
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/04/2026
Initial Report FDA Received Date08/11/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured10/28/2022
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Patient SexUnknown
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