FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 1840062 · Received September 15, 2010

Report

Report Number
2028159-2010-01732
Event Type
Malfunction
Date Received
September 15, 2010
Date of Event
August 13, 2010
Report Date
August 16, 2010
Manufacturer
ALCON - IRVINE TECHNOLOGY CENTER
Product Code
HQC
PMA / PMN Number
K082845
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION INCLUDING ROOT CAUSE ANALYSIS IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY WHEN ADDITIONAL REPORTABLE INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

ADVERSE EVENT(S): "NO PT INVOLVED" (NO PT INVOLVEMENT). PRODUCT PROBLEM(S): "SYSTEM MESSAGE DISPLAYED" (DEVICE DISPLAYS ERROR MESSAGE. THE NURSE REPORTED THE SYSTEM WOULD NOT TUNE THE HANDPIECE AND A SYSTEM MESSAGE DISPLAYED. THE HANDPIECE WAS SWITCHED OUT WITH THE SAME RESULT. THE SYSTEM WAS SWITCHED OUT AND THE CASE PROCEEDED. NO PT WAS INVOLVED

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INFINITI VISION SYSTEM OZIL PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER INFINITI OZIL NA

Patients

Seq Age Sex Outcome Treatment
1 UNK