FDA Adverse Event Malfunction Summary report: N

CONSTELLATION WITH LASER

MDR report key: 2072384 · Received April 8, 2011

Report

Report Number
2028159-2011-00352
Event Type
Malfunction
Date Received
April 8, 2011
Date of Event
March 1, 2011
Report Date
March 9, 2011
Manufacturer
ALCON - IRVINE TECHNOLOGY CTR
Product Code
HQC
PMA / PMN Number
K063583
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION INCLUDING ROOT CAUSE ANALYSIS IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY WHEN ADDITIONAL REPORTABLE INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

A SURGEON REPORTED THAT DURING SURGERY, THE VERTICAL SCISSORS TIP CAME OFF A PNEUMATIC HANDPIECE WHILE IN THE PT'S EYE. THERE HAVE BEEN REPORTS OF ANY PT HARM ASSOCIATED WITH THIS EVENT. ADDITIONAL INFO HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CONSTELLATION WITH LASER UNIT, PHACOFRAGMENTATION HQC ALCON - IRVINE TECHNOLOGY CTR CONSTELLATION NA

Patients

Seq Age Sex Outcome Treatment
1 CONSTELLATION SYSTEM