FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 16884253 · Received May 8, 2023

Report

Report Number
3001421318-2023-01629
Event Type
Malfunction
Date Received
May 8, 2023
Date of Event
April 10, 2023
Report Date
May 8, 2023
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002813549
PMA / PMN Number
K181216
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

REPLACED THE OXYGEN QUICK DISCONNECT PORT (LPO) AND CONFIRMED THAT THE LEAK WAS ELIMINATED. PERFORMED MANUFACTURE'S RECOMMENDED CHECKS AND CALIBRATIONS. DEVICE PASSED ALL CHECKS AND TESTS. HAMILTON MEDICAL AG CASE NUMBER IS: (B)(4).

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: BIOP-MED STATED THAT THE HAMILTON MEDICAL CLINICAL SPECIALIST ENCOUNTERED A LPO PORT LEAK DURING CLINICAL TRAINING AND REQUESTED THAT THE VENTILATOR BE REPAIRED. NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
600149 HAMILTON MEDICAL AG HAMILTON-T1 CBK HAMILTON MEDICAL AG HAMILTON-T1 07630002813549

Patients

Seq Age Sex Outcome Treatment
1 Unknown