MAUDE Adverse Event Report: Drive Medical DeVilbiss 10-liter oxygen concentrator; GENERATOR, OXYGEN, PORTABLE

Model Number	1025DS
Medical Device Problem Code	Fire (1245)
Health Effect - Clinical Code	Burn(s) (1757)
Date of Event	05/07/2026
Type of Reportable Event	Death
Event or Problem Description
Drive medical was notified of an incident from a device provider's attorney regarding a death from an oxygen tank or oxygen concentrator allegedly causing house fire.The patient died at hospital from injuries.The cause of the fire is unknown; no allegations.Drive medical is currently investigating the incident, including attempting to inspect the device.An update will be filed if additional information becomes available.

• Brand Name: DeVilbiss 10-liter oxygen concentrator
• Common Device Name: GENERATOR, OXYGEN, PORTABLE
• Manufacturer (Section D): Drive Medical; 100 devilbiss drive; somerset PA 15501
• Manufacturer (Section G): Drive Medical; 100 devilbiss drive; somerset PA 15501
• Manufacturer Contact: jess bohrer ; 100 devilbiss drive; somerset, PA 15501 ; +1(516)998-4600
• MDR Report Key: 50589252
• Report Number: 2515872-2026-00027
• Device Sequence Number: 10068342
• Product Code: CAW
• UDI-Device Identifier: 00885304022466
• UDI-Public: (01)00885304022466
• Combination Product (Y/N): N
• Initial Reporter State: FL
• Initial Reporter Country: US
• PMA/510(K) Number: K071397
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• Report Date (Section B): 09/03/2026

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Operator of Device: Lay User/Patient
• Device Model Number: 1025DS
• 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: Not provided
• Initial Report FDA Received Date: 09/03/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 02/28/2023
• 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
• Usage of Device: Unknown
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Death
• Patient Sex: Male