FDA Adverse Event Malfunction Summary report: N

HAMILTON-T1

MDR report key: 18372167 · Received December 21, 2023

Report

Report Number
3001421318-2023-12705
Event Type
Malfunction
Date Received
December 21, 2023
Date of Event
July 7, 2022
Report Date
August 29, 2024
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
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 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 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 PREPARED FOR TREATMENT. THE ROOT CAUSE OF THE EVENT WAS DETERMINED TO BE A DEFECTIVE FILTER PRESSURE SENSOR BOARD AND/OR A DEFECTIVE CONTROL BOARD. IN CONSEQUENCE (CORRECTION) THE FILTER PRESSURE SENSOR BOARD AND THE CONTROL BOARD WERE REPLACED. THERE WAS NO PATIENT OR USER HARM REPORTED. 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 AS REQUESTED.

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 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 PREPARED FOR TREATMENT. THE ROOT CAUSE OF THE EVENT WAS DETERMINED TO BE A DEFECTIVE FILTER PRESSURE SENSOR BOARD AND/OR A DEFECTIVE CONTROL BOARD. IN CONSEQUENCE (CORRECTION) THE FILTER PRESSURE SENSOR BOARD AND THE CONTROL BOARD WERE REPLACED. THERE WAS NO PATIENT OR USER HARM REPORTED.

Description of Event or Problem · 0

RTC RESET AFTER BUZZER TEST COULDN'T START VENTILATION.

Description of Event or Problem · 0

RTC RESET AFTER BUZZER TEST COULDN'T START VENTILATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
277414 HAMILTON-T1 HAMILTON-T1 CBK HAMILTON MEDICAL AG 161009

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown