FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 17609883 · Received August 24, 2023

Report

Report Number
3001421318-2023-28355
Event Type
Malfunction
Date Received
August 24, 2023
Date of Event
May 20, 2020
Report Date
August 22, 2023
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
00730002856789
PMA / PMN Number
K201306
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KE
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

SINCE THE COMPLAINT IN QUESTION WAS SUBMITTED TO HAMILTON MEDICAL AG ALMOST 2 YEARS 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 NOT IN USE. THE ROOT CAUSE WAS DETERMINED AS PER THE RGA#75414 TO BE A FAILURE TRACED TO A FAULTY PRESSURE SENSOR BOARD. IN CONSEQUENCE THE PRESSURE SENSOR ASSEMBLY WAS REPLACED, AND NO OTHER FAILURES WERE REGISTERED FOR THIS MACHINE. THERE WAS NO PATIENT OR USER HARM.

Description of Event or Problem · 0

THE MACHINE IS UNABLE TO PASS TIGHTNESS AND FLOW SENSOR TESTS.FLOW TEST-SERVICE MODE, PROXIMAL FLOW SENSOR QAW - NOT OK; AUTOZERO TEST, QAW; PAW, PVENT MONITOR AND PVENT CONTROL - NOT OK

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
306733 HAMILTON MEDICAL AG HAMILTON-C3 CBK HAMILTON MEDICAL AG HAMILTON-C3 00730002856789

Patients

Seq Age Sex Outcome Treatment
1 Unknown