FDA Adverse Event Injury Summary report: N

HAMILTON-C3

MDR report key: 19317059 · Received May 14, 2024

Report

Report Number
3001421318-2024-01153
Event Type
Injury
Date Received
May 14, 2024
Date of Event
May 8, 2024
Report Date
November 14, 2024
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002801881
PMA / PMN Number
K201306
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: BLOWER DEFECTIVE. CORRECTION: REPLACED DEFECTIVE COMPONENT.

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG COMES TO THE CONCLUSION: ROOTCAUSE: BLOWER DEFECTIVE. CORRECTION: REPLACED DEFECTIVE COMPONENT.

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG COMES TO THE CONCLUSION: ROOTCAUSE: BLOWER MODULE DEFECTIVE. CORRECTION: REPLACED DEFECTIVE COMPONENT.

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG COMES TO THE CONCLUSION: ROOTCAUSE: BLOWER MODULE DEFECTIVE. CORRECTION: REPLACED DEFECTIVE COMPONENT. ADDITIONAL INFORMATION: H4, H6. CORRECTED INFORMATION: B1, D4, H6, B11. HAMILTON MEDICAL AG COMPLAINT NUMBER: (B)(4). FOLLOW-UP 3 - CORRECTED INFORMATION: **UDI RELATED DATA QUALITY UPDATES ONLY** FIELD D4 WAS UPDATED WITH FULL UDI INFORMATION, UPDATED FIELDS: B4, D1, D2A, D4, D8, G1, G2, G6, H2, H4, H5.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: SUMMARY: TE231009 OCCURRED AND THE DEVICE DIDN'T VENTILATE AS SETTINGS. SPO2 DECREASED TEMPORALLY, BUT IT WAS RECOVERED BY MANUAL VENTILATION AND THE VENTILATOR REPLACEMENT.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: SUMMARY: TE231009 OCCURRED AND THE DEVICE DIDN'T VENTILATE AS SETTINGS. SPO2 DECREASED TEMPORALLY, BUT IT WAS RECOVERED BY MANUAL VENTILATION AND THE VENTILATOR REPLACEMENT.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: SUMMARY: (B)(6) OCCURRED AND THE DEVICE DIDN'T VENTILATE AS SETTINGS. SPO2 DECREASED TEMPORALLY, BUT IT WAS RECOVERED BY MANUAL VENTILATION AND THE VENTILATOR REPLACEMENT.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: SUMMARY: TE231009 OCCURRED AND THE DEVICE DIDN'T VENTILATE AS SETTINGS. SPO2 DECREASED TEMPORALLY, BUT IT WAS RECOVERED BY MANUAL VENTILATION AND THE VENTILATOR REPLACEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
488679 HAMILTON-C3 HAMILTON-C3 CBK HAMILTON MEDICAL AG 160005 07630002801881

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention