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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 1020006
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 device was sent to a third-party service center for investigation.During the evaluation, the third-party service center noted a melted cable.The device will be forwarded to the manufacturer¿s product investigation lab (pil) for additional testing and investigation.A follow up report will be sent once the investigation is concluded.
 
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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 Key50268677
Report Number2518422-2026-043297
Device Sequence Number18709864
Product Code CAW
UDI-Device Identifier00606959032552
UDI-Public(01)00606959032552
Combination Product (Y/N)N
Initial Reporter CountrySP
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 Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 08/17/2026
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 Other
Device Model Number1020006
Device Catalogue Number1020006
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 08/12/2026
Initial Report FDA Received Date08/17/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured08/08/2022
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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