FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 18129841 · Received November 14, 2023

Report

Report Number
3001421318-2023-22448
Event Type
Malfunction
Date Received
November 14, 2023
Date of Event
May 19, 2021
Report Date
November 8, 2023
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
00730002856789
PMA / PMN Number
K181216
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
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 (B)(6) TO (B)(6) 2022 AT THE EMS AND BONADUZ SITES. A DETAILED INVESTIGATION WAS PERFORMED BY AN EXPERT FROM THE TECHNICAL SERVICE: WITH THIS INVESTIGATION IT HAS BEEN CONFIRMED THAT THE DEVICE FAILED TO MEET ITS SPECIFICATIONS AT THE TIME OF THE EVENT. THE ROOT CAUSE OF THE VENTILATOR WAS A DEFECTIVE CO2 SENSOR (CAPNOSTAT-5). THERE WAS NO PATIENT OR USER HARM. THE ALLEGATION IN THIS COMPLAINT WAS CONFIRMED TO BE A COMPLAINT. 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.

Description of Event or Problem · 0

DURING VENTILATION LOW CO2 APPEARED AND NO CO2 WAVE WAS VISIBLE. CALIBRATION HAS BEEN PERFORMED WITH AIRWAY ADAPTER. REPLACEMENT WITH DIFFERENT CAPNOSTAT-5 COULD SOLVE THE PROBLEM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2041792 HAMILTON MEDICAL AG HAMILTON-T1 CBK HAMILTON MEDICAL AG HAMILTON-T1 00730002856789

Patients

Seq Age Sex Outcome Treatment
1 Unknown