FDA Adverse Event Malfunction Summary report: N

HAMILTON-C6

MDR report key: 19678077 · Received July 5, 2024

Report

Report Number
3001421318-2024-01603
Event Type
Malfunction
Date Received
July 5, 2024
Date of Event
June 28, 2024
Report Date
November 18, 2024
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002808590
PMA / PMN Number
K201658
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG COMES TO THE CONCLUSION: INVESTIGATION ONGOING.

Additional Manufacturer Narrative · 0

A DETAILED INVESTIGATION WAS PERFORMED BY AN EXPERT FROM THE TECHNICAL SERVICE: 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. WITH THIS INVESTIGATION IT HAS BEEN CONFIRMED THAT THE DEVICE FAILED TO MEET ITS SPECIFICATIONS AT THE TIME OF THE EVENT WHILE THE VENTILATOR WAS IN USE. THE ROOT CAUSE WAS DETERMINED TO BE A BROKEN SEAL RING IN THE INSPIRATORY VALVE. IN CONSEQUENCE THE VALVE WAS REPLACED. THERE WAS NO PATIENT OR USER HARM REPORTED.

Additional Manufacturer Narrative · 0

A DETAILED INVESTIGATION WAS PERFORMED BY AN EXPERT FROM THE TECHNICAL SERVICE: 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. WITH THIS INVESTIGATION IT HAS BEEN CONFIRMED THAT THE DEVICE FAILED TO MEET ITS SPECIFICATIONS AT THE TIME OF THE EVENT WHILE THE VENTILATOR WAS IN USE. THE ROOT CAUSE WAS DETERMINED TO BE A BROKEN SEAL RING IN THE INSPIRATORY VALVE. IN CONSEQUENCE THE VALVE WAS REPLACED. THERE WAS NO PATIENT OR USER HARM REPORTED. HAMILTON MEDICAL AG COMPLAINT NUMBER: (B)(4). FOLLOW-UP 2 - CORRECTED INFORMATION: UDI RELATED DATA QUALITY UPDATES ONLY. FIELD D4 WAS UPDATED WITH FULL UDI INFORMATION. UPDATED FIELDS: B4, D1, D3, D4, G1, G6, H2, H4, H5, H11.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: SUMMARY: TECHNICAL EVENT 231005 (INSPIRATION VALVE LEAK) APPEARED VARIOUS TIMES DURING VENTILATION. DEVICE REMOVED FROM USE, ALTERNATIVE VENTILATION USED. NO PATIENT HARM.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: SUMMARY: TECHNICAL EVENT 231005 (INSPIRATION VALVE LEAK) APPEARED VARIOUS TIMES DURING VENTILATION. DEVICE REMOVED FROM USE, ALTERNATIVE VENTILATION USED. NO PATIENT HARM.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: SUMMARY: TECHNICAL EVENT 231005 (INSPIRATION VALVE LEAK) APPEARED VARIOUS TIMES DURING VENTILATION. DEVICE REMOVED FROM USE, ALTERNATIVE VENTILATION USED. NO PATIENT HARM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
477587 HAMILTON-C6 HAMILTON-C6 VENTILATOR CBK HAMILTON MEDICAL AG 160021 07630002808590

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown