FDA Adverse Event Death Summary report: N

HAMILTON-C6

MDR report key: 18525229 · Received January 17, 2024

Report

Report Number
3001421318-2024-00144
Event Type
Death
Date Received
January 17, 2024
Date of Event
January 12, 2024
Report Date
October 11, 2024
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002808590
PMA / PMN Number
K201658
Adverse Event
Yes
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 COMES TO THE CONCLUSION: ROOTCAUSE: INVESTIGATION ONGOING. HAMILTON MEDICAL AG COMPLAINT NUMBER: (B)(4). FOLLOW-UP 2 - CORRECTED INFORMATION: UDI RELATED DATA QUALITY UPDATES ONLY. FIELD D4 WAS UPDATED WITH FULL UDI INFORMATION.

Additional Manufacturer Narrative · 0

ON JUL 2, 2024, THE MENTOR FAILURE ANALYSIS LAB RECEIVED THE DEVICE FOR EVALUATION. DEVICE EVALUATION SUMMARY: THE PRODUCT WAS RETURNED TO MENTOR FOR EVALUATION. MENTOR CONDUCTED A VISUAL INSPECTION OF THE RETURNED DEVICE. VISUAL ANALYSIS OF THE RETURNED SAMPLE REVEALED THAT THE GEL MOD-RND 300CC BREAST IMPLANT WAS FOUND TO BE RUPTURED AND RECEIVED IN (3) THREE PARTS. IN ADDITION, SHELL ABRASION WAS NOTED ON THE EDGES OF THE RUPTURE. THE EVALUATION DETERMINED THAT THE POSSIBLE CAUSE OF THE RUPTURE WAS CONSISTENT WITH NORMAL WEAR. SHELL ABRASION SUGGESTS IN-VIVO FOLDING OR CREASING OF THE DEVICE. THIS MAY BE THE RESULT OF THE FOLLOWING FACTORS: CONTINUOUS AND SUSTAINED STRESSES TO THE DEVICE SUCH AS TOO SMALL BREAST POCKET AND FOLDING OR WRINKLING OF THE SHELL IN THE BREAST POCKET. IN SOME CASES, THE BREAST IMPLANTS MAY ALSO WEAR OUT OVER TIME. AS PART OF MENTOR¿S QUALITY PROCESS, ALL DEVICES ARE MANUFACTURED, INSPECTED, AND RELEASED TO APPROVED SPECIFICATIONS. MANUFACTURER¿S REFERENCE NUMBER: (B)(4).

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG COMES TO THE CONCLUSION: ROOTCAUSE: INVESSTIGATION ONGOING.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: AFTER MIDNIGHT ON JANUARY 12, THE SCREEN OF THE HAMILTON-C6 WENT BLACK, SO THE DEVICE WAS REPLACED WITH ANOTHER VENTILATOR, BUT A PATIENT PASSED AWAY AT AROUND 1:15. THE SITUATION AT THE TIME OF THE INCIDENT WAS THAT THE PATIENT WAS BEING CARED FOR AT THE END OF HIS LIFE, SO HIS FAMILY WAS WITH THE PATIENT, AND THE FAMILY CONTACTED THE NURSE ABOUT THE BLACKOUT PHENOMENON, THEN THE NURSE CONTACTED THE CE TO DISCUSS HOW TO DEAL WITH IT. THE CE WAS NOT AT THE HOSPITAL, SO A DOCTOR AND THE NURSE REPLACED THE C6 WITH ANOTHER VENTILATOR. AFTER THAT, DURING THE DAYTIME SHIFT, THE CE TRIED TO TURN OFF THE DEVICE, BUT IT WOULDN'T TURN OFF. HE COULD RESTART IT BY TURNING THE MAIN SWITCH ON AND OFF SEVERAL TIMES, BUT WHEN IT STARTED UP, THE STATUS BAR OF LOADING STOPPED AT ABOUT 80% AND SCREEN WAS FROZEN. AT AROUND 11 A.M. , OUR BRANCH STAFF VISITED THE SITE TO CHECK THE SITUATION AND STARTED UP THE SYSTEM, THEN IT STARTED IT UP PROPERLY AND THEY COULD EXPORT LOG FILES.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: AFTER MIDNIGHT ON JANUARY 12, THE SCREEN OF THE HAMILTON-C6 WENT BLACK, SO THE DEVICE WAS REPLACED WITH ANOTHER VENTILATOR, BUT A PATIENT PASSED AWAY AT AROUND 1:15. THE SITUATION AT THE TIME OF THE INCIDENT WAS THAT THE PATIENT WAS BEING CARED FOR AT THE END OF HIS LIFE, SO HIS FAMILY WAS WITH THE PATIENT, AND THE FAMILY CONTACTED THE NURSE ABOUT THE BLACKOUT PHENOMENON, THEN THE NURSE CONTACTED THE CE TO DISCUSS HOW TO DEAL WITH IT. THE CE WAS NOT AT THE HOSPITAL, SO A DOCTOR AND THE NURSE REPLACED THE C6 WITH ANOTHER VENTILATOR. AFTER THAT, DURING THE DAYTIME SHIFT, THE CE TRIED TO TURN OFF THE DEVICE, BUT IT WOULDN'T TURN OFF. HE COULD RESTART IT BY TURNING THE MAIN SWITCH ON AND OFF SEVERAL TIMES, BUT WHEN IT STARTED UP, THE STATUS BAR OF LOADING STOPPED AT ABOUT 80% AND SCREEN WAS FROZEN. AT AROUND 11 A.M. , OUR BRANCH STAFF VISITED THE SITE TO CHECK THE SITUATION AND STARTED UP THE SYSTEM, THEN IT STARTED IT UP PROPERLY AND THEY COULD EXPORT LOG FILES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
395546 HAMILTON-C6 HAMILTON-C6 VENTILATOR CBK HAMILTON MEDICAL AG 160021 07630002808590

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention| D