FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 18718888 · Received February 16, 2024

Report

Report Number
3001421318-2023-42041
Event Type
Malfunction
Date Received
February 16, 2024
Date of Event
November 30, 2022
Report Date
February 15, 2024
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
00730002856789
PMA / PMN Number
K181216
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IS
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 WAS DETERMINED TO BE ESM BOARD PN-161658 IN CONSEQUENCE THE CORRECTION TO REPLACE THE ESM BOARD RESOLVED THE ISSUE. THERE WAS NO PATIENT OR USER HARM.

Description of Event or Problem · 0

DEAR MILAD, A CUSTOMER HAD A PROBLEM WITH A C1 UNIT: ALERTED ON TF283005 TF249011. WE COULDN'T REPRODUCED THE PROBLEM. PLEASE ADVISE HILEL YAFE SC2202225 B.R. ILAN OFMAN BEPEX LTD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1910360 HAMILTON MEDICAL AG HAMILTON-C1 CBK HAMILTON MEDICAL AG HAMILTON-C1 00730002856789

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown