FDA Adverse Event Malfunction Summary report: N

HAMILTON-C1

MDR report key: 17866837 · Received October 4, 2023

Report

Report Number
3001421318-2023-03440
Event Type
Malfunction
Date Received
October 4, 2023
Date of Event
April 19, 2023
Report Date
September 6, 2024
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002800747
PMA / PMN Number
K181216
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG CASE NUMBER IS: (B)(4).

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG CASE NUMBER IS: (B)(4). WITHIN THE UDI-PI PROJECT, HAMILTON MEDICAL DID REALIZE THAT THE REPORTED DEVICE (BRAND NAME: HAMILTON-C1 / MODEL NUMBER: 161003 / CATALOG NUMBER: 161003) IN THE PRESENT MDR IS NOT FULFILLING THE CRITERIA OF SIMILARITY FOR A DEVICE MARKETED IN THE U.S., THEREFORE THIS EVENT IS NO LONGER CONSIDERED REPORTABLE TO FDA AND NO UDI-PI IS GOING TO BE PROVIDED.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: THE CUSTOMER COMPLAINED OF OCCASIONAL HIGH OXYGEN ALARMS WHILE USING THIS C1 ON PATIENTS AND ASKED THE LOCAL STAFF TO REPAIR THE C1. NO PATIENT HARM OR CONSEQUENCES. REPLACEMENT OF VENTILATOR.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: THE CUSTOMER COMPLAINED OF OCCASIONAL HIGH OXYGEN ALARMS WHILE USING THIS C1 ON PATIENTS AND ASKED THE LOCAL STAFF TO REPAIR THE C1. NO PATIENT HARM OR CONSEQUENCES. REPLACEMENT OF VENTILATOR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
200954 HAMILTON-C1 HAMILTON-C1 CBK HAMILTON MEDICAL AG 161003 07630002800747

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown