FDA Adverse Event Malfunction Summary report: N

HAMILTON-G5

MDR report key: 18010889 · Received October 26, 2023

Report

Report Number
3001421318-2023-03668
Event Type
Malfunction
Date Received
October 26, 2023
Date of Event
October 5, 2023
Report Date
October 14, 2024
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002800013
PMA / PMN Number
K193228
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE HAMILTON-S1 IS NOT DISTRIBUTED IN THE UNITED STATES; HOWEVER, HAMILTON MEDICAL AG CONSIDERS THE HAMILTON-S1 SIMILAR TO THE HAMILTON-G5 (K193228) IN THAT THE TWO VENTILATORS HAVE BASIC DESIGN AND PERFORMANCE CHARACTERISTICS RELATED TO DEVICE SAFETY AND EFFECTIVENESS, HAVE THE SAME INTENDED USE AND FUCTION, AND HAVE THE SAME DEVICE CLASSIFICATION AND PRODUCT CODE UNDER 21 CFR 868.5895. INVESTIGATION IS ONGOING. HAMILTON MEDICAL AG COMPLAINT NUMBER: (B)(4). FOLLOW-UP 1 - CORRECTED INFORMATION: **UDI RELATED DATA QUALITY UPDATES ONLY** FIELD D4 WAS UPDATED WITH FULL UDI INFORMATION. PLEASE NOTE THAT THE PREVIOUS NARRATIVE ABOVE NEEDS TO BE CORRECTED: THE DEVICE IN QUESTION WAS A HAMILTON-G5 (K193228, BRAND NAME: HAMILTON-G5; VERSION / MODEL / CATALOG NUMBER: 159001) WHICH WAS DISTRIBUTED IN THE UNITED STATES. CORRESPONDING FIELDS WERE UPDATED.

Additional Manufacturer Narrative · 0

THE HAMILTON-S1 IS NOT DISTRIBUTED IN THE UNITED STATES; HOWEVER, HAMILTON MEDICAL AG CONSIDERS THE HAMILTON-S1 SIMILAR TO THE HAMILTON-G5 (K193228) IN THAT THE TWO VENTILATORS HAVE BASIC DESIGN AND PERFORMANCE CHARACTERISTICS RELATED TO DEVICE SAFETY AND EFFECTIVENESS, HAVE THE SAME INTENDED USE AND FUCTION, AND HAVE THE SAME DEVICE CLASSIFICATION AND PRODUCT CODE UNDER 21 CFR 868.5895. INVESTIGATION IS ONGOING.

Description of Event or Problem · 0

REPORT FROM USER IS AS FOLLOWS "ONE OF THE S1'S HAS BEEN GIVING THE WRONG INFORMATION. IT HAD A HUMIDIFIED CIRCUIT IN AND HAS BEEN RUNNING OK FOR THE LAST FEW DAYS. OVER NIGHT, STAFF HAVE REPORTED THE RESPIRATORY RATE WAS REORDERING AT >80BPM AND THE VT HAD OBSCURE READINGS.".

Description of Event or Problem · 0

REPORT FROM USER IS AS FOLLOWS "ONE OF THE S1'S HAS BEEN GIVING THE WRONG INFORMATION. IT HAD A HUMIDIFIED CIRCUIT IN AND HAS BEEN RUNNING OK FOR THE LAST FEW DAYS. OVER NIGHT, STAFF HAVE REPORTED THE RESPIRATORY RATE WAS REORDERING AT >80BPM AND THE VT HAD OBSCURE READINGS."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1674006 HAMILTON-G5 HAMILTON-G5 VENTILATOR CBK HAMILTON MEDICAL AG 159001 07630002800013

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown