FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 17624033 · Received August 25, 2023

Report

Report Number
3001421318-2023-20823
Event Type
Malfunction
Date Received
August 25, 2023
Date of Event
August 13, 2021
Report Date
August 24, 2023
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
00730002856789
PMA / PMN Number
K181216
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NZ
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS ISSUE IS DEEMED A REPORTABLE EVENT SINCE THE MALFUNCTION UNTIGHT OR DEFECTIVE PRESSURE SENSOR BOARD/ASSEMBLY OR UNTIGHT OR DEFECTIVE AUTOZERO VALVE" LED TO AN INOPERABLE VENTILATOR. THE ROOT CAUSE OF THE VENTILATOR WAS A MALFUNCTION OF THE PRESSURE SENSOR ASSEMBLY. WITHIN THIS INVESTIGATION IT HAS BEEN CONFIRMED THAT THE DEVICE FAILED TO MEET ITS SPECIFICATIONS AT THE TIME OF THE EVENT. 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.

Description of Event or Problem · 0

ALARMING WHEN STARRTING UP AND SELF TEST FAILED. TECHNICAL EVENTS: 285002, 285002, 233001, 23304, 233003, 233006, 246005, 232035.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1918418 HAMILTON MEDICAL AG HAMILTON-T1 CBK HAMILTON MEDICAL AG HAMILTON-T1 00730002856789

Patients

Seq Age Sex Outcome Treatment
1 Unknown