FDA Adverse Event Malfunction Summary report: N

OPHTHALAS 532 EYELITE LASE SYSTEM

MDR report key: 1840793 · Received September 17, 2010

Report

Report Number
2028159-2010-01786
Event Type
Malfunction
Date Received
September 17, 2010
Date of Event
August 18, 2010
Report Date
August 19, 2010
Manufacturer
ALCON - IRVINE TECHNOLOGY CENTER
Product Code
GEX
PMA / PMN Number
K914334
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 INFORMATION BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

A CUSTOMER REPORTED A PROBLEM WITH THE FOOTSWITCH. THE SCHEDULED CASE WAS CANCELED. THE CUSTOMER INDICATED THE FOOTSWITCH HAD BEEN REPLACED 20 DAYS PRIOR TO THIS EVENT. THERE WAS NO PATIENT INJURY REPORTED. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OPHTHALAS 532 EYELITE LASE SYSTEM LASER INSTRUMENT, SURGICAL, POWERED GEX ALCON - IRVINE TECHNOLOGY CENTER 8065500001 NA

Patients

Seq Age Sex Outcome Treatment
1