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 |