FDA Adverse Event Malfunction Summary report: N

HAMILTON MEDICAL AG

MDR report key: 18900838 · Received March 14, 2024

Report

Report Number
3001421318-2023-42660
Event Type
Malfunction
Date Received
March 14, 2024
Date of Event
October 27, 2022
Report Date
March 13, 2024
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
00730002856789
PMA / PMN Number
K201306
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
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: 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. THE ROOT CAUSE OF THE ISSUE WAS NOT DETERMINED. THE ISSUE CANNOT BE DUPLICATED. THE DEVICE PASSED SERVICE SOFTWARE TESTING AND WAS PUT BACK IN SERVICE. THERE WAS NO PATIENT OR USER HARM.

Description of Event or Problem · 0

"RT SAID THE C3 WAS SHOWING FLOW WAVE FORM WITH PATIENT BREATHING BUT ALARMING APNEA"

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2076548 HAMILTON MEDICAL AG HAMILTON-C3 CBK HAMILTON MEDICAL AG HAMILTON-C3 00730002856789

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown