BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HAMILTON MEDICAL AG

    MDR report key: 18462001 · Received January 8, 2024

    Report

    Report Number
    3001421318-2023-26415
    Event Type
    Malfunction
    Date Received
    January 8, 2024
    Date of Event
    October 2, 2020
    Report Date
    January 5, 2024
    Manufacturer
    HAMILTON MEDICAL AG
    Product Code
    CBK
    UDI-DI
    00730002856789
    PMA / PMN Number
    K153046
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PL
    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 OVER 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. THE ROOT CAUSE WAS DETERMINED TO BE DEFECTIVE COMPONENTS OF THE VENTILATOR. IT COULD NOT BE DETERMINED MORE SPECIFICALLY. IN CONSEQUENCE THE COMPONENTS WERE REPLACED. THERE WAS NO PATIENT OR USER HARM.

    Description of Event or Problem · 0

    FAN FAILURE - YELLOW ALARM. THE FAN NO ROTARY. I CHECKED IT IN C-1, NO EFFECT. I CAN'T UPDATE TESLASPY BOARD. TESLASPY WORK CORRECTLY, BUT MIUPDATER SHOW MESSAGE - NO COMMUNICATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    620926 HAMILTON MEDICAL AG HAMILTON-MR1 CBK HAMILTON MEDICAL AG HAMILTON-MR1 00730002856789

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown