FDA Adverse Event Malfunction Summary report: N

HAMILTON-G5

MDR report key: 16239054 · Received January 25, 2023

Report

Report Number
3001421318-2023-00029
Event Type
Malfunction
Date Received
January 25, 2023
Date of Event
December 14, 2022
Report Date
April 2, 2024
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002800013
PMA / PMN Number
K193228
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

NO HARM CAME TO THE PATIENT. VENTILATOR WAS NOT RETURNED TO HMAG. INVESTIGATION HAS BEEN INITIATED AND IS ONGOING. THIS FILE REPORTS THE EVENT STATED IN HAMILTON MEDICAL AG CASE NUMBER (B)(4).

Additional Manufacturer Narrative · 0

DEVICE DID NOT RETURN TO HAMILTON MEDICAL AG. WE RECEIVED THE LOG FILES OF THE DEVICE AND THE ALARMS WERE REGISTERED IN THE LOG FILES. VENTILATION CONTINUES BUT WITH INCORRECT O2 CONCENTRATION SINCE THE MIXER VALVE WAS DEFECTIVE. TECHNICIAN REPLACED BOTH MIXER VALVES TO SOLVE THE PROBLEM. DEVICE IS BACK IN USE. THIS FILE REPORTS THE EVENT STATED IN HAMILTON MEDICAL AG CASE NUMBER CER (B)(4).

Additional Manufacturer Narrative · 0

A DETAILED INVESTIGATION WAS PERFORMED BY AN EXPERT FROM THE TECHNICAL SERVICE: SINCE THE COMPLAINT IN QUESTION WAS SUBMITTED TO HAMILTON MEDICAL AG MORE THAN ONE YEAR AGO, NO ATTEMPTS WILL BE PERFORMED TO OBTAIN ADDITIONAL INFORMATION. NO FURTHER INVESTIGATION OR CORRECTION WILL BE PERFORMED EXCEPT THOSE MENTIONED ABOVE. IN FUTURE HAMILTON MEDICAL AG WILL REPORT AN EVENT SIMILAR TO THIS ISSUE AS IT WILL BE DEEMED A REPORTABLE EVENT. THE ALLEGATION IN THIS COMPLAINT WAS CONFIRMED TO BE A COMPLAINT. WITH THIS INVESTIGATION IT HAS BEEN CONFIRMED THAT THE DEVICE FAILED TO MEET ITS SPECIFICATIONS AT THE TIME OF THE EVENT WHILE THE VENTILATOR WAS USED. THE ROOT CAUSE OF THIS COMPLAINT WAS THE AIR INLET MIXER VALVES NOT OPENING PROPERLY. IN CONSEQUENCE (CORRECTION) THE MIXER VALVES WERE REPLACED. NO PATIENT OR USER HARM WAS REPORTED.

Description of Event or Problem · 0

HAMILTON MEDICAL AG RECEIVED THE FOLLOWING EVENT DESCRIPTION: "DEVICE SHOWED THE RED ALARM "NO OXYGEN SUPPLY" DURING VENTILATION. DEVICE CHECKED WITH MANUFACTURER SOFTWARE. NO MISTAKE NOTICABLE. THE DEVICE ALSO SHOWS THE RED ALARMS "DISCONNECTION PATIENT SIDE; PEEP LOSS; PRESSURE TOO HIGH; TIDAL VOLUME LOW" IN THE EVENT LOG." NO PATIENT HARM WAS REPORTED.

Description of Event or Problem · 0

HAMILTON MEDICAL AG RECEIVED THE FOLLOWING EVENT DESCRIPTION: "DEVICE SHOWED THE RED ALARM "NO OXYGEN SUPPLY" DURING VENTILATION. DEVICE CHECKED WITH MANUFACTURER SOFTWARE. NO MISTAKE NOTICABLE. THE DEVICE ALSO SHOWS THE RED ALARMS "DISCONNECTION PATIENT SIDE; PEEP LOSS; PRESSURE TOO HIGH; TIDAL VOLUME LOW" IN THE EVENT LOG." NO PATIENT HARM WAS REPORTED.

Description of Event or Problem · 0

HAMILTON MEDICAL AG RECEIVED THE FOLLOWING EVENT DESCRIPTION: "DEVICE SHOWED THE RED ALARM "NO OXYGEN SUPPLY" DURING VENTILATION. DEVICE CHECKED WITH MANUFACTURER SOFTWARE. NO MISTAKE NOTICABLE. THE DEVICE ALSO SHOWS THE RED ALARMS "DISCONNECTION PATIENT SIDE; PEEP LOSS; PRESSURE TOO HIGH; TIDAL VOLUME LOW" IN THE EVENT LOG." NO PATIENT HARM WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1176797 HAMILTON-G5 HAMILTON-G5 VENTILATOR CBK HAMILTON MEDICAL AG HAMILTON-G5 07630002800013

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown