FDA Adverse Event Malfunction Summary report: N

HAMILTON-MR1

MDR report key: 19858914 · Received July 30, 2024

Report

Report Number
3001421318-2024-01804
Event Type
Malfunction
Date Received
July 30, 2024
Date of Event
July 1, 2024
Report Date
July 23, 2025
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002800761
PMA / PMN Number
K153046
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG CASE NUMBER IS (B)(4).

Additional Manufacturer Narrative · 0

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.

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG CASE NUMBER IS (B)(4). 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, D4, G6, H2, H4, H11. FOLLOW-UP 2 - ADDITIONAL INFORMATION: THE ENTRY FIELDS B4, G6, H2, H3, H6 AND H11 HAVE BEEN UPDATED. IT WAS REPORTED THAT THE DEVICE GENERATED A "FAN FAILURE" ALARM. NO PATIENT INVOLVEMENT. CONSEQUENTLY, THE EVENT DID NOT CAUSE OR CONTRIBUTE TO A DEATH OR SERIOUS INJURY TO A PATIENT. THE CUSTOMER DID NOT PROVIDE EVENT LOGS FOR ANALYSIS. A REPLACEMENT FAN WAS SHIPPED TO THE CUSTOMER. NO CONFIRMATION WAS RECEIVED REGARDING THE RESOLUTION OF THE ISSUE. ALTHOUGH THE OUTCOME COULD NOT BE VERIFIED, IT IS ASSUMED THAT THE ISSUE WAS RESOLVED BY REPLACING THE FAN, AS NO FURTHER COMPLAINTS HAVE BEEN REPORTED.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: - HAMILTON MEDICAL AG RECEIVED THE FOLLOWING INCIDENT DESCRIPTION: "FAN FAILURE". - WHEN THIS WAS NOTICED, THE VENTILATOR WAS NOT IN USE TO VENTILATE A PATIENT. NO FURTHER DETAILS ABOUT WHEN THIS HAPPENED WERE REPORTED TO HAMILTON MEDICAL AG. - THERE IS NO PATIENT INVOLVEMENT REPORTED. - 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 ONGOING.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: HAMILTON MEDICAL AG RECEIVED THE FOLLOWING INCIDENT DESCRIPTION: "FAN FAILURE". WHEN THIS WAS NOTICED, THE VENTILATOR WAS NOT IN USE TO VENTILATE A PATIENT. NO FURTHER DETAILS ABOUT WHEN THIS HAPPENED WERE REPORTED TO HAMILTON MEDICAL AG. THERE IS NO PATIENT INVOLVEMENT REPORTED. 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 ONGOING.

Description of Event or Problem · 0

THE FOLLOWING WAS REPORTED TO HAMILTON MEDICAL AG: - HAMILTON MEDICAL AG RECEIVED THE FOLLOWING INCIDENT DESCRIPTION: "FAN FAILURE". - WHEN THIS WAS NOTICED, THE VENTILATOR WAS NOT IN USE TO VENTILATE A PATIENT. NO FURTHER DETAILS ABOUT WHEN THIS HAPPENED WERE REPORTED TO HAMILTON MEDICAL AG. - THERE IS NO PATIENT INVOLVEMENT REPORTED. - 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 ONGOING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
187245 HAMILTON-MR1 HAMILTON-MR1 CBK HAMILTON MEDICAL AG 161010 NOT APPLICABLE 07630002800761

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown