FDA Adverse Event Malfunction Summary report: N

SERIES TWENTY THOUSAND LEGACY

MDR report key: 1052559 · Received May 22, 2008

Report

Report Number
2028159-2008-00183
Event Type
Malfunction
Date Received
May 22, 2008
Report Date
April 22, 2008
Manufacturer
ALCON - IRVIN TECHNOLOGY CENTER
Product Code
HQE
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE RETURNED FOOTPEDAL WAS VISUALLY INSPECTED AND FOUND TO HAVE HEAVY WEAR. THE STRAIN RELIEF OF THE FOOTPEDAL CABLE WAS NOT IN ITS ORIGINAL PLACE. THE FOOTPEDAL WAS TESTED AND MET ALL FUNCTIONAL SPECIFICATIONS INCLUDING GROUND ISOLATION AND GROUND RESISTANCE. A REVIEW OF COMPLAINTS AND SERVICE DATA FOR BOTH THE SYSTEM AND FOOTPEDAL INDICATES THAT THERE HAVE BEEN NO ADDITIONAL COMPLAINTS OR SERVICE REQUESTS RELATED TO THE REPORTED EVENT. COMPLAINT TRENDING INDICATES NO RECENT ADVERSE TRENDS ASSOCIATED WITH THE COMPLAINT. THE ROOT CAUSE OF THE COMPLAINT CANNOT BE DETERMINED IN THIS INVESTIGATION.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT FOOTSWITCH HAD A SHORT IN IT. TWO CASES WERE CANCELLED. NO PT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SERIES TWENTY THOUSAND LEGACY OPHTALMIC SURGERY SYSTEM HQE ALCON - IRVIN TECHNOLOGY CENTER STTL NA

Patients

Seq Age Sex Outcome Treatment
1 NI