FDA Adverse Event Malfunction Summary report: N

HAMILTON-T1

MDR report key: 19338510 · Received May 17, 2024

Report

Report Number
3001421318-2024-01165
Event Type
Malfunction
Date Received
May 17, 2024
Date of Event
May 6, 2024
Report Date
January 3, 2025
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002801850
PMA / PMN Number
K181216
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG CASE NUMBER IS (B)(4). INVESTIGATION ONGOING. HAMILTON MEDICAL AG COMPLAINT NUMBER: (B)(4). FOLLOW-UP 1 - CORRECTED INFORMATION: **UDI RELATED DATA QUALITY UPDATES ONLY** FIELD D4 WAS UPDATED WITH FULL UDI INFORMATION. UPDATED FIELDS: B4, D1, D4, G6, H2, H4, H11.

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG CASE NUMBER IS CER (B)(4). INVESTIGATION ONGOING.

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG CASE NUMBER IS (B)(4). INVESTIGATION ONGOING. HAMILTON MEDICAL AG COMPLAINT NUMBER: (B)(4). FOLLOW-UP 1 - CORRECTED INFORMATION: UDI RELATED DATA QUALITY UPDATES ONLY FIELD D4 WAS UPDATED WITH FULL UDI INFORMATION. UPDATED FIELDS. A DETAILED INVESTIGATION WAS PERFORMED BY AN EXPERT FROM THE TECHNICAL SERVICE: DEVICE LOGS WERE NOT PROVIDED. THE INVESTIGATION WAS DONE BASED ON THE ANALYSIS OF THE TECHNICIAN ON SITE. THE ALARM "LOW OXYGEN" CAN HAVE SEVERAL REASONS SUCH AS TEMPERATURE INFLUENCE OR AN EXPIRED O2 CELL. THE O2 CELL WAS REPLACED BUT THE ISSUE REMAINED. THEN THE O2 MIXER ASSEMBLY (PART N° MSP161609) WAS REPLACED AND THE DEVICE FUNCTIONED AS INTENDED AGAIN. THEREFORE, THE ROOT CAUSE WAS CONFIRMED TO BE A DEFECTIVE O2 MIXER ASSEMBLY. THE MALFUNCTION OF THE O2 MIXER ASSEMBLY CAN CAUSE THE VENTILATOR NOT TO REACH THE REQUIRED OXYGEN LEVEL. IN THIS CASE THE DEVICE NOTIFIES THE USER BY GIVING AN ALARM "LOW OXYGEN". IF THE USER DOES NOT REACT ACCORDINGLY TO THE ALARM A DETERIORATION OF THE STATE OF HEALTH OF THE PATIENT CANNOT BE EXCLUDED. THEREFORE, THIS CASE WAS ASSESSED AS BEING REPORTABLE.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: - THIS EVENT WAS REPORTED TO HAMILTON MEDICAL AG AS, VENTILATOR DEVICE DID NOT REACH 100% O2. - THIS OCCURRENCE WAS NOTICED DURING PATIENT VENTILATION. - WHETHER ALARMS WERE TRIGGERED WAS NOT REPORTED. - THE DEVICE LOG FILES (SERVICE LOG, ERROR LOG, EVENT LOG) WERE PROVIDED TO HAMILTON MEDICAL AG. - THIS MALFUNCTIONING WAS REPRODUCIBLE. - THERE IS PATIENT INVOLVEMENT REPORTED. THIS OCCURRENCE WAS NOTICED DURING PATIENT VENTILATION BUT WAS NOT FURTHER SPECIFIED NOR EXPLAINED. - THERE IS NO NEED FOR ANY MEDICAL INTERVENTION REPORTED. - NEITHER DELAY IN TREATMENT NOR HARM TO THE PATIENT, USER OR THIRD PARTY HAS BEEN REPORTED. THE INVESTIGATION IS STILL ONGOING.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: - THIS EVENT WAS REPORTED TO HAMILTON MEDICAL AG AS, VENTILATOR DEVICE DID NOT REACH 100% O2. - THIS OCCURRENCE WAS NOTICED DURING PATIENT VENTILATION. - WHETHER ALARMS WERE TRIGGERED WAS NOT REPORTED. - THE DEVICE LOG FILES (SERVICE LOG, ERROR LOG, EVENT LOG) WERE PROVIDED TO HAMILTON MEDICAL AG. - THIS MALFUNCTIONING WAS REPRODUCIBLE. - THERE IS PATIENT INVOLVEMENT REPORTED. THIS OCCURRENCE WAS NOTICED DURING PATIENT VENTILATION BUT WAS NOT FURTHER SPECIFIED NOR EXPLAINED. - THERE IS NO NEED FOR ANY MEDICAL INTERVENTION REPORTED. - NEITHER DELAY IN TREATMENT NOR HARM TO THE PATIENT, USER OR THIRD PARTY HAS BEEN REPORTED. THE INVESTIGATION IS STILL ONGOING.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: THIS EVENT WAS REPORTED TO HAMILTON MEDICAL AG AS, VENTILATOR DEVICE DID NOT REACH 100% O2. THIS OCCURRENCE WAS NOTICED DURING PATIENT VENTILATION. WHETHER ALARMS WERE TRIGGERED WAS NOT REPORTED. THE DEVICE LOG FILES (SERVICE LOG, ERROR LOG, EVENT LOG) WERE PROVIDED TO HAMILTON MEDICAL AG. THIS MALFUNCTIONING WAS REPRODUCIBLE. THERE IS PATIENT INVOLVEMENT REPORTED. THIS OCCURRENCE WAS NOTICED DURING PATIENT VENTILATION BUT WAS NOT FURTHER SPECIFIED NOR EXPLAINED. THERE IS NO NEED FOR ANY MEDICAL INTERVENTION REPORTED. NEITHER DELAY IN TREATMENT NOR HARM TO THE PATIENT, USER OR THIRD PARTY HAS BEEN REPORTED. THE INVESTIGATION IS STILL ONGOING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2519695 HAMILTON-T1 HAMILTON-T1 CBK HAMILTON MEDICAL AG 161006 07630002801850

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown