BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    INIFINITI VISION SYSTEM

    MDR report key: 1940085 · Received December 22, 2010

    Report

    Report Number
    2028159-2010-02459
    Event Type
    Malfunction
    Date Received
    December 22, 2010
    Report Date
    December 10, 2010
    Manufacturer
    ALCON - IRVINE TECHNOLOGY CENTER
    Product Code
    HQC
    PMA / PMN Number
    K021566
    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 IN ACCORDANCE WITH 21 CFR 803.56 WHEN ADDITIONAL REPORTABLE INFO BECOMES AVAILABLE. (B)(4).

    Description of Event or Problem · 1

    A CUSTOMER REPORTED THE FOOTSWITCH WAS NOT WORKING DURING A PROCEDURE. THE SURGERY WAS CONCLUDED FOLLOWING AN EXCHANGE OF THE FOOTSWITCH AND 10 MINUTE DELAY. NO PT INJURY OR HARM REPORTED.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1