BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HAMILTON VENTILATOR

    MDR report key: 10553097 · Received September 17, 2020

    Report

    Report Number
    MW5096730
    Event Type
    Injury
    Date Received
    September 17, 2020
    Date of Event
    September 10, 2020
    Report Date
    September 15, 2020
    Manufacturer
    HAMILTON MEDICAL, INC.
    Product Code
    CBK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CO, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    VENTILATOR STOPPED WORKING WHILE CONNECTED TO THE PATIENT AND WAS NOT VENTILATING THE PATIENT. VENTILATOR WAS PLUGGED INTO APPROPRIATE ELECTRICAL OUTLET. FDA SAFETY REPORT ID # (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1011908 HAMILTON VENTILATOR VENTILATOR, CONTINUOUS, FACILITY USE CBK HAMILTON MEDICAL, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 53 YR Life Threatening