FDA Adverse Event Injury Summary report: N

INFINITI VISION SYSTEM OZIL

MDR report key: 2143091 · Received June 23, 2011

Report

Report Number
2028159-2011-00702
Event Type
Injury
Date Received
June 23, 2011
Date of Event
May 1, 2011
Report Date
May 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 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 INFORMATION BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

A SURGEON REPORTED DURING A CATARACT EXTRACTION PROCEDURE, HE NOTICED WHITENING OF THE PATIENT'S CORNEA AT THE BEGINNING OF THE PROCEDURE. SUBSEQUENTLY, THE PATIENT EXPERIENCED A CORNEAL BURN. NO OCCLUSION BELL WAS HEARD. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

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 OZIL TORSIONAL HANDPIECE