MAUDE Adverse Event Report: Hamilton Medical AG Breathing Circuit Set, Coaxial

Model Number	260128
Medical Device Problem Code	Obstruction of Flow (2423)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/28/2026
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported to hamilton medical ag, that: "time of incident around 1800hrs, out of hospital cardiac arrest, intubated patient in emergency department.Once connected patient to ventilator, "exhalation obstruction" alarm was noted.No harm to patient.Unable to definitively state actual batch of hamilton circuit used as the packaging was accidently discarded." patient involvement with medical intervention in the form of the patient being disconnected from the ventilator and placed on bvm, while the ventilator circuit was replaced, was reported.No patient, user or third party harm was reported.
Additional Manufacturer Narrative
Hamilton medical ag reference number: (b)(4).Investigation is ongoing.Hmag reference number: (b)(4),fda reference: (b)(4).

• Brand Name: Breathing Circuit Set, Coaxial
• Common Device Name: Breathing Circuit Set, Coaxial
• Manufacturer (Section D): Hamilton Medical AG; via crusch 8; bonaduz 7402 ; SZ 7402
• Manufacturer Contact: jan schaufelberger ; via crusch 8; bonaduz 7402 ; SZ 7402
• MDR Report Key: 50815023
• Report Number: 3001421318-2026-00574
• Device Sequence Number: 10158138
• Product Code: BZO
• UDI-Device Identifier: 07630002802963
• UDI-Public: (01)07630002802963
• Combination Product (Y/N): N
• Initial Reporter Country: AS
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Foreign,Health Professional,User Facility,Distributor
• Remedial Action: Notification,Recall
• Type of Report: Initial
• Report Date (Section B): 09/18/2026

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: 260128
• Device Catalogue Number: 260128
• Device Lot Number: 201444 or 202129 or 200355
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 08/31/2026
• Initial Report FDA Received Date: 09/18/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Sex: Unknown