FDA Adverse Event Malfunction Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 1941678 · Received December 10, 2010

Report

Report Number
2028159-2010-02337
Event Type
Malfunction
Date Received
December 10, 2010
Report Date
November 10, 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
WV, US
Reporter Occupation
UNKNOWN

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 ADD'L REPORTABLE INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

A SURGICAL REP REPORTED THAT DURING SURGERY, A SYSTEM MESSAGE WAS DISPLAYED. THERE WAS A FIVE MINUTE DELAY AND THE SURGEON WAS ABLE TO COMPLETE THE PROCEDURE WITH NO HARM TO THE PT. THIS IS THE SECOND OF TWO SIMILAR REPORTS FROM THIS FACILITY.

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 NI