FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 17850009 · Received October 2, 2023

Report

Report Number
3001421318-2023-26750
Event Type
Malfunction
Date Received
October 2, 2023
Date of Event
September 23, 2020
Report Date
September 29, 2023
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
00730002856789
PMA / PMN Number
K201306
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PK
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE COMPLAINT HAS BEEN REOPENED AND REVIEWED ACCORDING TO FDA FORM 483 INSPECTIONAL OBSERVATION EMS #2, EOBS2 FROM THE FDA INSPECTION CONDUCTED BETWEEN JULY 17 TO JULY 21, 2022 AT THE EMS AND BONADUZ SITES. A DETAILED INVESTIGATION WAS PERFORMED BY AN EXPERT FROM THE TECHNICAL SERVICE: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 THE 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. BASED ON THE COURSE OF EVENTS, OBSERVATIONS AND INSTRUMENT LOGS, THE ROOT CAUSE FOR THE DEVICE FAILURE WERE FLOW SENSOR SENSING LINES OF THE DEVICE THAT WERE DISCONNECTED OR OCCLUDED. IN SUCH A SITUATION, THE VENTILATOR SWITCHES OVER TO PCV+ MODE AND DISPLAYS VENTILATOR PRESSURE (PVENT) INSTEAD OF PAW. THE TECHNICAL SOLUTION WAS AN EXCHANGE OF THE INSPIRATORY VALVE (MSP160230). THE CORRECTION SOLVED THE TECHNICAL PROBLEM; NO FURTHER CER WAS REGISTERED FOR THIS DEVICE.

Description of Event or Problem · 0

VENTILATOR SHOWS TECHNICAL FAULT 431017. WHICH IS NOT FOUND IN C TROUBLESHOOTING PLATFORM. PLEASE SUGGEST US TO RESOLVE THE PROBLEM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1975934 HAMILTON MEDICAL AG HAMILTON-C3 CBK HAMILTON MEDICAL AG HAMILTON-C3 00730002856789

Patients

Seq Age Sex Outcome Treatment
1 Unknown