FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 17651460 · Received August 30, 2023

Report

Report Number
3001421318-2023-12061
Event Type
Malfunction
Date Received
August 30, 2023
Date of Event
August 2, 2022
Report Date
August 29, 2023
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
00730002856789
PMA / PMN Number
K201658
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NO
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 PREPARED FOR TREATMENT. THE ROOT CAUSE WAS DETERMINED TO BE A DEFECTIVE PRESSURE SENSOR ASSEMBLY (PSA). IN CONSEQUENCE THE PRESSURE SENSOR ASSEMBLY HAS BEEN REPLACED. THERE WAS NO PATIENT OR USER HARM.

Description of Event or Problem · 0

VOLUME- AND FLOW-CURVES ARE UNSTABLE AND DOES NOT GIVE THE RIGHT WAVES ON THE TEST LUNG.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1287609 HAMILTON MEDICAL AG HAMILTON-C6 CBK HAMILTON MEDICAL AG HAMILTON-C6 00730002856789

Patients

Seq Age Sex Outcome Treatment
1 Unknown