FDA Adverse Event
Malfunction
Summary report: N
NA
MDR report key: 1058786
·
Received June 9, 2008
Report
- Report Number
- 2090040-2008-00004
- Event Type
- Malfunction
- Date Received
- June 9, 2008
- Date of Event
- May 9, 2008
- Report Date
- June 9, 2008
- Manufacturer
- ASCENT HEALTHCARE SOLUTIONS
- Product Code
- NKX
- PMA / PMN Number
- K050518
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- VA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE USED DEVICE HAS BEEN RETURNED, HOWEVER A DEVICE ANALYSIS HAS NOT YET BEEN COMPLETED. UPON COMPLETION OF THE INVESTIGATION A FOLLOW-UP MEDWATCH WILL BE SUBMITTED.
Description of Event or Problem · 1
BEFORE THE PROCEDURE STARTED, THE PHACO TIP WAS NOT OSCILLATING AND BROKE OFF. THE TIP FELL INTO PATIENT'S EYE AND WAS RETRIEVED. NO PT INJURY WAS REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | NA | NKX | ASCENT HEALTHCARE SOLUTIONS |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |