FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 17593670 · Received August 22, 2023

Report

Report Number
3001421318-2023-10809
Event Type
Malfunction
Date Received
August 22, 2023
Date of Event
September 18, 2022
Report Date
August 21, 2023
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
00730002856789
PMA / PMN Number
K121225
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IS
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS ISSUE IS DEEMED A REPORTABLE EVENT SINCE THE TE 233003 AND TE 233004 MALFUNCTION CAN LEAD TO A DELAY IN THE THERAPY SINCE THE VENTILATOR CANNOT BE USED (IFU: "MUST BE SERVICED"). A FULLY FUNCTIONING VENTILATOR NEEDS TO BE PREPARED. THE ROOT CAUSE OF THE VENTILATOR TO ALARM WITH TE 233003 AND TE 233004 WAS DETERMINED TO BE A DEFECTIVE PRESSURE SENSOR ASSEMBLY (PSA) AND DEFECTIVE MAINBOARD. WITH THIS INVESTIGATION IT HAS BEEN CONFIRMED THAT THE DEVICE FAILED TO MEET ITS SPECIFICATIONS AT THE TIME OF THE EVENT, WHILE THE MEDICAL DEVICE WAS USED FOR TREATMENT. THERE WAS NO PATIENT OR USER HARM. THE ALLEGATION IN THIS COMPLAINT WAS CONFIRMED TO BE A COMPLAINT. NO FURTHER INVESTIGATION OR CORRECTION WILL BE PERFORMED EXCEPT THOSE MENTIONED ABOVE. IN FUTURE HAMILTON MEDICAL AG WILL REPORT AN EVENT LIKE THIS ISSUE AS IT WILL BE DEEMED A REPORTABLE EVENT.

Description of Event or Problem · 0

DEAR MILAD, A CUSTOMER HAD A PROBLEM WITH THIS UNIT: ALERTED SEVERAL TIMES ON TF 233004. HE DID ALL THE TESTS BUT COULDN'T REPRODUCED THE PROBLEM. PLEASE ADVISE. B.R. ILAN OFMAN BEPEX LTD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2329220 HAMILTON MEDICAL AG HAMILTON-C2 CBK HAMILTON MEDICAL AG HAMILTON-C2 00730002856789

Patients

Seq Age Sex Outcome Treatment
1 Unknown