MAUDE Adverse Event Report: HAMILTON MEDICAL AG HAMILTON-C2

Model Number	160002
Medical Device Problem Codes	Gas Output Problem (1266); Medical Gas Supply Problem (2985)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	06/27/2024
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Hamilton medical ag comes to the conclusion: investigation ongoing.
Event or Problem Description
The following was reported to hamilton medical ag: summary: oxygen supply failed.
Event or Problem Description
The following was reported to hamilton medical ag: summary: oxygen supply failed.
Additional Manufacturer Narrative
Hamilton medical ag comes to the conclusion: investigation ongoing.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, d1, d2a, d4, g6, h2, h4, h5, h11.
Additional Manufacturer Narrative
Hamilton medical ag comes to the conclusion: investigation ongoing.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, d1, d2a, d4, g6, h2, h4, h5, h11.Follow-up 2 - additional information: the entry fields b4, g6, h2, h3, h6 and h11 have been updated.It was reported that an "oxygen supply failed" event occurred.There was no patient involvement or and consequently no clinical consequences were reported.The customer was provided with a replacement mixer valve assembly to address the issue.No log files were submitted for analysis, and no feedback was received confirming whether the replacement resolved the problem.Although the outcome could not be verified, it is assumed that the issue was resolved by replacing the mixer assembly, as no further issues have been reported.
Event or Problem Description
The following was reported to hamilton medical ag: summary: oxygen supply failed.

• Brand Name: HAMILTON-C2
• Common Device Name: HAMILTON-C2
• Manufacturer (Section D): HAMILTON MEDICAL AG; via crusch 8; bonaduz, switzerland 7402 ; SZ 7402
• Manufacturer Contact: daniel elice ; via crusch 8; bonaduz, switzerland 7402 ; SZ 7402
• MDR Report Key: 19709294
• Report Number: 3001421318-2024-01652
• Device Sequence Number: 6851613
• Product Code: CBK
• UDI-Device Identifier: 07630002800730
• UDI-Public: (01)07630002800730(21)12683(11)170704(240)160002
• Combination Product (Y/N): N
• Initial Reporter Country: US
• PMA/510(K) Number: K121225
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Y
• Reporter Type: Manufacturer
• Report Source: Health Professional,User Facility,Distributor
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 07/30/2025

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Operator of Device: Health Professional
• Device Model Number: 160002
• Device Catalogue Number: 160002
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 07/01/2024
• Supplement Date Received by Manufacturer: 07/01/2024; 07/01/2024
• Initial Report FDA Received Date: 07/10/2024
• Supplement Report FDA Received Date: 11/15/2024; 07/30/2025
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 07/04/2017
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Reuse
• Patient Sequence Number: 1
• Patient Sex: Unknown