FDA Adverse Event Malfunction Summary report: N

HAMILTON-S1

MDR report key: 19200335 · Received April 29, 2024

Report

Report Number
3001421318-2024-01046
Event Type
Malfunction
Date Received
April 29, 2024
Date of Event
April 12, 2024
Report Date
November 26, 2024
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
505

Narratives

Additional Manufacturer Narrative · 0

THE HAMILTON-S1 IS NOT DISTRIBUTED IN THE UNITED STATES; HOWEVER, HAMILTON MEDICAL AG CONSIDERS THE HAMILTON-S1 SIMILAR TO THE HAMILTON-G5 (K193228) IN THAT THE TWO VENTILATORS HAVE BASIC DESIGN AND PERFORMANCE CHARACTERISTICS RELATED TO DEVICE SAFETY AND EFFECTIVENESS, HAVE THE SAME INTENDED USE AND FUCTION, AND HAVE THE SAME DEVICE CLASSIFICATION AND PRODUCT CODE UNDER 21 CFR 868.5895. INVESTIGATION IS ONGOING.

Additional Manufacturer Narrative · 0

THE HAMILTON-S1 IS NOT DISTRIBUTED IN THE UNITED STATES; HOWEVER, HAMILTON MEDICAL AG CONSIDERS THE HAMILTON-S1 SIMILAR TO THE HAMILTON-G5 (K193228) IN THAT THE TWO VENTILATORS HAVE BASIC DESIGN AND PERFORMANCE CHARACTERISTICS RELATED TO DEVICE SAFETY AND EFFECTIVENESS, HAVE THE SAME INTENDED USE AND FUCTION, AND HAVE THE SAME DEVICE CLASSIFICATION AND PRODUCT CODE UNDER 21 CFR 868.5895. INVESTIGATION IS ONGOING. A DETAILED INVESTIGATION WAS PERFORMED BY AN EXPERT FROM THE TECHNICAL SERVICE: 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. THE ROOT CAUSE WAS DETERMINED TO BE AUTOZERO VALVES ON THE SENSOR BOARD NOT WORKING PROPERLY. IN CONSEQUENCE THE SENSOR BOARD 2 WAS REPLACED (P/N (B)(6)). THE UNIT PASSED ALL TESTS AND WAS THEN OPERATIONAL. THERE WAS NO PATIENT OR USER HARM. THIS DEVICE WAS PRODUCED BEFORE 2015. NO UDI AVAILABLE.

Additional Manufacturer Narrative · 0

THE HAMILTON-S1 IS NOT DISTRIBUTED IN THE UNITED STATES; HOWEVER, HAMILTON MEDICAL AG CONSIDERS THE HAMILTON-S1 SIMILAR TO THE HAMILTON-G5 (K193228) IN THAT THE TWO VENTILATORS HAVE BASIC DESIGN AND PERFORMANCE CHARACTERISTICS RELATED TO DEVICE SAFETY AND EFFECTIVENESS, HAVE THE SAME INTENDED USE AND FUCTION, AND HAVE THE SAME DEVICE CLASSIFICATION AND PRODUCT CODE UNDER 21 CFR 868.5895. INVESTIGATION IS ONGOING. A DETAILED INVESTIGATION WAS PERFORMED BY AN EXPERT FROM THE TECHNICAL SERVICE: 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. THE ROOT CAUSE WAS DETERMINED TO BE AUTOZERO VALVES ON THE SENSOR BOARD NOT WORKING PROPERLY. IN CONSEQUENCE THE SENSOR BOARD 2 WAS REPLACED (P/N 155699). THE UNIT PASSED ALL TESTS AND WAS THEN OPERATIONAL. THERE WAS NO PATIENT OR USER HARM. THIS DEVICE WAS PRODUCED BEFORE 2015. NO UDI AVAILABLE. HAMILTON MEDICAL AG COMPLAINT NUMBER: CER (B)(4) FOLLOW-UP 2 - CORRECTED INFORMATION: WITHIN THE UDI-PI PROJECT, HAMILTON MEDICAL REALIZED THAT THE REPORTED DEVICE (BRAND NAME: HAMILTON-S1; VERSION / MODEL / CATALOG NUMBER: 159005) IN THE PRESENT MDR IS NOT FULFILLING THE CRITERIA OF SIMILARITY FOR A DEVICE MARKETED IN THE U.S., THEREFORE THIS EVENT IS NO LONGER CONSIDERED REPORTABLE TO FDA AND NO UDI-PI IS GOING TO BE PROVIDED.

Description of Event or Problem · 0

HAMILTON MEDICAL AG RECEIVED THE FOLLOWING INCIDENT DESCRIPTION: THE DEVICE ALARMED WITH TF 5510, 5511 DURING STANDBY.

Description of Event or Problem · 0

HAMILTON MEDICAL AG RECEIVED THE FOLLOWING INCIDENT DESCRIPTION: THE DEVICE ALARMED WITH TF 5510, 5511 DURING STANDBY.

Description of Event or Problem · 0

HAMILTON MEDICAL AG RECEIVED THE FOLLOWING INCIDENT DESCRIPTION: THE DEVICE ALARMED WITH TF 5510, 5511 DURING STANDBY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
999864 HAMILTON-S1 HAMILTON-S1 VENTILATOR CBK HAMILTON MEDICAL AG 159005

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown