FDA Adverse Event Injury Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 2003607 · Received February 22, 2011

Report

Report Number
2028159-2011-00160
Event Type
Injury
Date Received
February 22, 2011
Date of Event
January 25, 2011
Report Date
January 24, 2011
Manufacturer
ALCON - IRVINE TECHNOLOGY CENTER
Product Code
HQC
PMA / PMN Number
K082845
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFO REGARDING PRODUCT EVAL IS PENDING. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY IN ACCORDANCE WHEN ADDITIONAL REPORTABLE INFO BECOMES AVAILABLE. A ROOT CAUSE HAS NOT BEEN IDENTIFIED. (B)(4).

Description of Event or Problem · 1

A SURGEON REPORTED DURING A CATARACT EXTRACTION PROCEDURE, A SYSTEM MESSAGE DISPLAYED AND THE CONSOLE STOPPED. THE SYSTEM DID NOT RECOVER AFTER EXCHANGING THE CASSETTE, HANDPIECE AND REBOOT. THE CASE WAS CONVERTED TO AN EXTRACAPSULAR CATARACT EXTRACTION TO CONCLUDE THE SURGERY WITHOUT FURTHER INCIDENT.

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 Required Intervention