FDA Adverse Event Malfunction Summary report: N

ACCURUS 800CS

MDR report key: 1843355 · Received September 22, 2010

Report

Report Number
2028159-2010-01796
Event Type
Malfunction
Date Received
September 22, 2010
Date of Event
August 23, 2010
Report Date
August 23, 2010
Manufacturer
ALCON - IRVINE TECHNOLOGY CENTER
Product Code
HQC
PMA / PMN Number
K911808
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE COMPANY SERVICE REP EXAMINED THE SYSTEM AND WAS UNABLE TO DUPLICATE THE PROBLEM REPORTED. NO SYSTEM MESSAGE WAS FOUND IN THE EVENT LOG. PREVENTIVE MAINTENANCE WAS PERFORMED. THE SYSTEM WAS THEN TESTED AND MET ALL PRODUCT SPECIFICATIONS. (B)(4).

Description of Event or Problem · 1

THE NURSE REPORTED THE SYSTEM WENT BLANK AND A SYSTEM MESSAGE DISPLAYED. THE SYSTEM WAS REBOOTED AND THE CASE WAS COMPLETED AS PLANNED. NO PT INJURY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCURUS 800CS PHACOFRAGMENTATION SYSTEM HQC ALCON - IRVINE TECHNOLOGY CENTER ACCURUS NA

Patients

Seq Age Sex Outcome Treatment
1 UNK