BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HAMILTON G5 #21

    MDR report key: 9166351 · Received October 7, 2019

    Report

    Report Number
    MW5090248
    Event Type
    Injury
    Date Received
    October 7, 2019
    Date of Event
    September 26, 2019
    Report Date
    October 3, 2019
    Manufacturer
    HAMILTON MEDICAL AG / HAMILTON MEDICAL, INC.
    Product Code
    CBK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    NO INFORMATION

    Narratives

    Description of Event or Problem · 1

    VENT ARM BUMPED SCREEN CAUSING IT TO GO BLANK AND CONTINUOUSLY ALARM; VENTILATOR STILL WORKING PROPERLY. VENT PULLED FROM SERVICE, SENT FOR INVESTIGATION OF ISSUE. NO HARM TO PT. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    957907 HAMILTON G5 #21 VENTILATOR, CONTINUOUS, FACILITY USE CBK HAMILTON MEDICAL AG / HAMILTON MEDICAL, INC. G5

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Required Intervention