FDA Adverse Event
Malfunction
Summary report: N
HAMILTON-C1
MDR report key: 19448759
·
Received June 3, 2024
Report
- Report Number
- 3001421318-2024-01359
- Event Type
- Malfunction
- Date Received
- June 3, 2024
- Date of Event
- April 8, 2024
- Report Date
- October 24, 2024
- Manufacturer
- HAMILTON MEDICAL AG
- Product Code
- CBK
- UDI-DI
- 07630002800747
- PMA / PMN Number
- K181216
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IN
- Reporter Occupation
- OTHER
- Health Professional
- N
Narratives
Additional Manufacturer Narrative · 0
HAMILTON MEDICAL AG CASE NUMBER IS: (B)(4).
Additional Manufacturer Narrative · 0
HAMILTON MEDICAL AG CASE NUMBER IS: (B)(4). FOLLOW-UP 1 - CORRECTED INFORMATION: FIELD D4 WAS UPDATED WITH FULL UDI INFORMATION. UPDATED FIELDS: B4, D1, D4, G6, H2, H4, H11.
Description of Event or Problem · 0
THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: TE 233003 (AUTOZERO ERROR QAW/PAW). SELF TEST FAILED . FAILURE OCCURS DURING THE GENERAL CHECK. THE PATIENT WAS NOT INVOLVED.
Description of Event or Problem · 0
THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: -TE 233003 (AUTOZERO ERROR QAW/PAW), -SELF TEST FAILED. FAILURE OCCURS DURING THE GENERAL CHECK. THE PATIENT WAS NOT INVOLVED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 594041 | HAMILTON-C1 | HAMILTON-C1 | CBK | HAMILTON MEDICAL AG | 161001 | 07630002800747 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |