FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 17806014 · Received September 25, 2023

Report

Report Number
3001421318-2023-26018
Event Type
Malfunction
Date Received
September 25, 2023
Date of Event
November 9, 2020
Report Date
September 22, 2023
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
00730002856789
Product Problem
Yes
Report Source
Manufacturer report
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 TO BE DEFECTIVE FLOATER DUE TO AGED CHAMBERS. IN CONSEQUENCE THE BREATHING SET WITH CHAMBER WAS REPLACED. THERE WAS NO PATIENT OR USER HARM.

Description of Event or Problem · 0

WATER CHAMBER OVERFILL WHEN WATER BAG WAS SPIKED DATE ON THE BACK OF THE WATER CHAMBER 200728.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1881111 HAMILTON MEDICAL AG HAMILTON-H900 CBK HAMILTON MEDICAL AG HAMILTON-H900 00730002856789

Patients

Seq Age Sex Outcome Treatment
1 Unknown