FDA Adverse Event
Malfunction
Summary report: N
KNIFE
MDR report key: 2030947
·
Received March 4, 2011
Report
- Report Number
- 2523835-2011-00018
- Event Type
- Malfunction
- Date Received
- March 4, 2011
- Date of Event
- January 31, 2011
- Report Date
- February 2, 2011
- Manufacturer
- ALCON PRECISION DEVICE - SINKING SPRING
- Product Code
- HNN
- PMA / PMN Number
- NA
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- LH
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE INVESTIGATION IS IN PROGRESS. THE DEVICE HISTORY RECORD (DHR) FOR THE LOT WAS REVIEWED. FUNCTIONAL PENETRATION TEST VALUES FOR THE LOT MET SPECIFICATION. NO ABNORMALITIES THAT COULD HAVE CONTRIBUTED TO A DULL KNIFE WERE FOUND DURING THE DHR REVIEW AND THE PRODUCT WAS RELEASED ACCORDING TO MANUFACTURE ACCEPTANCE CRITERIA. A ROOT CAUSE HAS NOT BEEN IDENTIFIED. (B)(4).
Description of Event or Problem · 1
A SURGEON REPORTED THAT A KNIFE REQUIRED EXCESSIVE FORCE IN ORDER TO CUT DURING A PROCEDURE. ANOTHER KNIFE WAS USED TO CONCLUDE THE PROCEDURE. THERE WAS NO HARM OR INJURY TO THE PATIENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | KNIFE | MANUAL OPHTHALMIC SURGICAL INSTRUMENT | HNN | ALCON PRECISION DEVICE - SINKING SPRING | 8065982465 | 807998M |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 58 YR |