FDA Adverse Event Malfunction Summary report: N

HAMILTON-G5

MDR report key: 22791125 · Received August 13, 2025

Report

Report Number
3001421318-2025-00748
Event Type
Malfunction
Date Received
August 13, 2025
Date of Event
July 17, 2025
Report Date
February 2, 2026
Manufacturer
HAMILTON MEDICAL AG
Product Code
CBK
UDI-DI
07630002802208
PMA / PMN Number
K193228
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG COMPLAINT NUMBER: (B)(4). INVESTIGATION ONGOING.

Additional Manufacturer Narrative · 0

HAMILTON MEDICAL AG COMPLAINT NUMBER: (B)(4). FOLLOW-UP 1: INVESTIGATION OUTCOME. HAMILTON MEDICAL AG RECEIVED THE LOGFILES OF THE DEVICE FOR ANALYSIS. UPON REVIEW OF THE LOGFILES, AIR AND OXYGEN SUPPLY ALARMS WERE RECORDED. PLEASE SEE BELOW AN EXTRACT FROM THE LOGFILES. LINE 122: 2025-07-31 11:30:21 OXYGEN + AIR SUPPLIES FAILED SUPPLY 5017, LINE 163: 2025-07-29 13:11:36 OXYGEN + AIR SUPPLIES FAILED SUPPLY 5017, LINE 240: 2025-07-29 12:46:46 OXYGEN + AIR SUPPLIES FAILED SUPPLY 5017, LINE 318: 2025-06-30 11:25:54 OXYGEN + AIR SUPPLIES FAILED SUPPLY 5017, LINE 387: 2025-06-17 01:33:58 OXYGEN + AIR SUPPLIES FAILED SUPPLY 5017, THE CENTER DISK AND MIXER BLOCK ASSEMBLY WERE INITIALLY REPLACED; HOWEVER, THESE ACTIONS DID NOT RESOLVE THE REPORTED CONDITION. THE ISSUE WAS SUBSEQUENTLY ATTRIBUTED TO A DEFECTIVE SERVO MODULE, WHICH WAS REPLACED. SUBSEQUENT TESTING IDENTIFIED NO ADDITIONAL ISSUES, AND THE VENTILATOR PASSED ALL REQUIRED SERVICE CHECKS. THE DEVICE WAS RETURNED TO SERVICE.

Description of Event or Problem · 0

HAMILTON MEDICAL AG RECEIVED THE FOLLOWING DESCRIPTION: THERE IS AIR LEAKING BETWEEN THE SERVO MODULE AND MIXER VALVE. NO PATIENT INVOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
299952 HAMILTON-G5 HAMILTON-G5 CBK HAMILTON MEDICAL AG 159002 07630002802208

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown