FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 17422457 · Received July 31, 2023

Report

Report Number
3001421318-2023-14490
Event Type
Malfunction
Date Received
July 31, 2023
Date of Event
April 29, 2022
Report Date
July 31, 2023
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002800372
PMA / PMN Number
K201658
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE COMPLAINT HAS BEEN REOPENED AND REVIEWED ACCORDING TO FDA FORM 483 INSPECTIONAL OBSERVATION EMS #2, EOBS2 FROM THE FDA INSPECTION CONDUCTED BETWEEN JULY 17 TO JULY 21, 2022 AT THE EMS AND BONADUZ SITES.  A DETAILED INVESTIGATION WAS PERFORMED BY AN EXPERT FROM THE TECHNICAL SERVICE: 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 PRESUMABLY PREPARED FOR TREATMENT. THE ROOT CAUSE WAS DETERMINED TO BE A DEFECT INFELLICUFF WHICH WAS REPLACED. THERE WAS NO PATIENT OR USER HARM.

Description of Event or Problem · 0

SELF TEST FAILED. 244020. UNIT ALARMING CONSTANTLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1840831 HAMILTON MEDICAL AG HAMILTON-C6 CBK HAMILTON MEDICAL AG HAMILTON-C6 07630002800372

Patients

Seq Age Sex Outcome Treatment
1 Unknown